title: [Unilateral essential hematuria: diagnosis, endoscopic treatment, and new diagnostic-therapeutic algorithm].
abstract: OBJECTIVE
  To perform a long-term evaluation of 15 patients with unilateral essential hematuria, with the aim of determining the causes of bleeding and the response to endoscopic treatment. To design a diagnostic-therapeutic algorithm for patients with unilateral essential hematuria.
  
  
  METHODS
  We retrospectively review the clinical data of 15 patients with unilateral essential hematuria evaluated by rigid ureterorenoscopy (15 cases), flexible ureteropyelocalycoscopy (15 cases) and percutaneous nephroscopy (3 cases). In 4 patients electric fulguration of the pyelocalicial lesions was carried out.
  
  
  RESULTS
  14 of the 15 patients were successfully treated endoscopically. Only one patient presented recurrence of the hematuria. Mean follow-up time was 64 months (4-168 months). No patient suffered any relevant complication secondary to the endoscopic treatment.
  
  
  CONCLUSIONS
  The cause of bleeding in patients with unilateral essential hematuria is determined only in a few, but endoscopic treatment is successful in a high percentage of cases. We consider that upper urinary tract endoscopy, mainly flexible ureteropyelocalycoscopy, has strongly impacted the diagnosis and treatment of essential unilateral hematuria. We present a new diagnostic-therapeutic algorithm, based on the usefulness of flexible instrumentation.
authors.affiliation: Servicio de Urología, Hospital Universitario, Guadalajara. aserranop@sescam.jccm.es
authors.forename: Alvaro
authors.initials: A
authors.lastname: Serrano
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Fernández
authors.forename: Pilar
authors.initials: P
authors.lastname: González-Peramato
authors.forename: Ignacio
authors.initials: I
authors.lastname: Otero
authors.forename: Javier
authors.initials: J
authors.lastname: Regadera
authors.forename: Jesús
authors.initials: J
authors.lastname: Golbano
authors.forename: Francisco
authors.initials: F
authors.lastname: Lovaco
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D004564:Electrocoagulation / Q000379:methods / Q000706:statistics & numerical data; D004724:Endoscopy / Q000706:statistics & numerical data*; D005260:Female; D006391:Hemangioma / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D006417:Hematuria / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007668:Kidney / Q000002:abnormalities; D007680:Kidney Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D018666:Ureteroscopy / Q000706:statistics & numerical data