Step by Step Flexible Ureteroscopy Supported with SPIES Technology for Conservative Treatment of UTUC

Abstract

Abstract Objective: To describe the step by step technique of flexible ureteroscopy (fURS) in the treatment of upper urinary tract carcinomas (UTUC) reporting the different modalities of visualization supplied by SPIES technology and to determine whether this enhancing system could improve the detection of malignancy. Materials and Methods: Twelve patients underwent 17 fURS procedures for UTUC using white light (WL) and the five modalities of SPIES technology (Clara, Chroma, Clara+Chroma, SPECTRA A, and SPECTRA B). Biopsies were carried out from all suspicious areas, reporting which modality they were seen with. All procedures were performed by a single urologist. Results: Optimal outcomes in the conservative management of UTUC are possible only with rigorous standardization of the procedure as follows: cystoscopy, ureteroscopy, urinary cytology in situ, navigation of the collecting system with WL and with SPIES technology (the different modalities are shown in the video), identification of the defect of ...