Bladder Chemoprophylaxis Following Ureterorenoscopy in Patients with Upper Tract Urothelial Carcinoma

Kidney-sparing procedures for upper tract urothelial carcinoma (UTUC) have evolved from imperative to elective indications for management of low-risk disease. Ureterorenoscopy is the most common procedure for the diagnosis, treatment, and surveillance of UTUC. A notable consideration following ureterorenoscopy is the higher risk of downstream bladder seeding. Here we review the importance of and scientific evidence for chemoprophylaxis after ureterorenoscopy. Patient summary: For patients with low-risk cancer of the upper urinary tract, a procedure called ureterorenoscopy (URS) involving insertion of a thin telescope through the ureter and into the kidney is increasingly used for biopsy. URS increases the risk of cancer seeding in the bladder. We review evidence on the benefit of prophylactic bladder chemotherapy after URS. (c) 2021 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Automated summary

Kidney-sparing procedures for low-risk upper tract urothelial carcinoma (UTUC) have become elective indications. Ureterorenoscopy (URS) is commonly used for diagnosis and treatment, but it carries a higher risk of bladder seeding. This review examines the importance and scientific evidence for chemoprophylaxis after URS.