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Nd:YAG laser irradiation in the treatment of upper tract urothelial tumors

Nineteen patients with upper tract filling defects were studied in order to determine their clinical diagnosis. In nine patients ureteropyeloscopy confirmed the presence of urothelial tumors of the upper urinary tract. In all the patients ureteroscopy and cold biopsy apparently localized low grade tumors. All the patients underwent Nd:YAG laser irradiation of the tumor and of the base utilizing 25-30 Watts for 3 sec. During the follow-up the patients had endoscopic surveillance every three months (average follow-up is 12 months). Ureteropyeloscopy seems to be an accurate form of evaluation and management of all upper urinary tract filling defects. It permits endoscopic access into ureter and renal pelvis, and coupled Nd:YAG laser it allows, in the same session, treatment of primarily low grade-low stage tumors by conservative approach and endoscopic means.