[Unilateral essential hematuria: diagnosis, endoscopic treatment, and new diagnostic-therapeutic algorithm].
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.
Serrano
Alvaro
A
Servicio de Urología, Hospital Universitario, Guadalajara. aserranop@sescam.jccm.es
Fernández
Inmaculada
I
González-Peramato
Pilar
P
Otero
Ignacio
I
Regadera
Javier
J
Golbano
Jesús
J
Lovaco
Francisco
F
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