The management of hydronephrosis in patients undergoing TURBT.
OBJECTIVE
Previous studies have shown the negative prognostic correlation of hydronephrosis in bladder cancer; however, practical uncertainties remain regarding the management of these patients.


METHODS
We retrospectively reviewed the notes of patients undergoing TURBT over a three year period and recorded the management and outcome of patients with hydronephrosis.


RESULTS
Six percent with bladder cancer had hydronephrosis. Nearly all the cases had muscle invasive disease. At TURBT, the ureteric orifice was seen in 41%; in the remaining 59% of patients, the ureteric orifice was involved and resected. This resolved the hydronephrosis in only one patient (who had superficial disease).


CONCLUSIONS
Hydronephrosis in bladder cancer is associated with a poor prognosis. The hydronephrosis does not resolve with resection alone. As awaiting it's resolution may delay definitive treatment, we suggest aggressive management of hydronephrosis from the time of initial diagnosis with ureteric stenting in order to protect renal units and optimize renal function prior to further definitive treatment of bladder cancer.
Thiruchelvam
N
N
Department of Urology, Royal Hampshire County Hospital, Romsey Road, SO22 5DG, Winchester, Hampshire, UK. n.t@talk21.com
Ubhayakar
G
G
Mostafid
H
H
D000465:Algorithms; D015653:Cystectomy / Q000379:methods; D006801:Humans; D006869:Hydronephrosis / Q000150:complications* / Q000628:therapy*; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000150:complications* / Q000601:surgery*