Upper urinary tract biopsy: an old device for a new approach.
OBJECTIVE
The authors sought to evaluate the feasibility, diagnostic accuracy and safety of urological biopsy performed using a flexible alligator forceps.


METHODS
Twenty-seven patients with suspected urothelial malignancy underwent retrograde biopsy using a 7-F biopsy forceps (Cordis, Miami, FL, USA). Mild sedation was guaranteed by an anaesthesiologist. The final diagnosis was confirmed by cytohistological data and subsequently by pathology findings at surgery. Lesions with benign histopathology were closely monitored for at least 12 months.


RESULTS
The technical success rate was 92.6%. The high diagnostic accuracy was related to the positive correspondence between histological outcomes and surgical results or follow-up observations. As regards sample site, the procedure was less successful in calyceal lesions than in lesions located in the upper urinary tract, with a technical success of 71.43%. Twenty patients had asymptomatic haematuria in the early hours after the procedure; ten of them had mild dysuria. No one require medication, and no major complications occurred.


CONCLUSIONS
Urological forceps biopsy is a safe and easy procedure. It provides a relatively high level of accuracy in the diagnosis of lesions of the upper urinary tract.
Interventional Radiology, Department of Radiology, Insubria University, Viale Borri 57, 21100, Varese, Italy. gcarraf@tin.it
G
G
Carrafiello
F
F
Fontana
M
M
Mangini
A M
AM
Ierardi
E
E
Cotta
F
F
Piacentino
M
M
De Chiara
C
C
Floridi
A
A
Di Massa
A M
AM
Marconi
C
C
Fugazzola
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000295:instrumentation*; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012680:Sensitivity and Specificity; D013525:Surgical Instruments; D014283:Triiodobenzoic Acids; D014571:Urologic Neoplasms / Q000473:pathology*
D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol