Laser - an effective treatment and an alternative solution for kidney removal...

Tumors of the ureter and renal pelvis are considered rare tumors, accounting for only 5-10% compared to the more common urinary bladder tumors.

Smoking and some hereditary genetic mutations are among the important causes of its occurrence.

Due to its rarity, treating it poses a challenge for doctors in selecting the best treatment, and it also requires exceptional expertise and long patience in using flexible endoscopes and lasers in a confined space such as the ureter to preserve the kidney in many cases instead of radical removal, especially in cases of a single kidney.

One of the difficult cases that we successfully handled recently, which posed a clear challenge for us, was a tumor measuring 2.5 cm in the middle of the right ureter in a single kidney with chronic renal failure. The presence of multiple twists in the ureter further complicated the case, making it extremely challenging to access the tumor through ureteroscopy.

Most of these cases are treated through radical nephrectomy via laparoscopic surgery.

However, the removal of the kidney in this case requires the patient to be continuously placed under dialysis, along with all the medical issues that accompany dialysis and its impact on the quality of life.

The patient was treated using both rigid and flexible ureteroscopy and laser technique over multiple sessions until complete removal of the tumor was achieved, along with chemical irrigation inside the ureter after each session.

The images below show the ureter before and after treatment, and the absence of tumor in the ureter after completing the treatment sessions while preserving the kidney without the need for dialysis.

The success of treating this case was a result of accumulated experience, a comprehensive study of the case, the use of the latest advanced technologies, in addition to the understanding and cooperation of the patient and their trust in the treatment team.

Dr. Khalid Al-Safi, Consultant in Urological and Reproductive Surgery.