Ureteroscopic Evaluation and Treatment of Chronic Unilateral Hematuria

PURPOSE: Chronic unilateral hematuria constitutes a difficult problem of diagnosis and treatment. We evaluated 23 patients with unilateral renal hematuria to determine the cause of bleeding and to evaluate ureteroscopic treatment. MATERIALS AND METHODS: A total of 23 patients with chronic unilateral hematuria were evaluated ureteroscopically during a 2-year period. Semirigid and flexible ureteroscopes were used to evaluate all patients. Dilation of the ureterovesical junction was required in only 1 patient. RESULTS: The entire ureter and intrarenal collecting system were inspected in all patients. Discrete lesions comprised hemangioma in 7, minute venous rupture in 3, small papillary tumor in 3 and calculus in 2 patients which were treated successfully. Nonspecific lesions comprised submucosal erythema in 2 patients and abnormal papillary tip in 1 which were treated successfully as well. In the remaining 5 patients no lesions were detected. In all treated patients hematuria resolved with no recurrence during a mean followup of 8 months (range 4 to 18). CONCLUSIONS: Ureteroscopy is an important diagnostic and therapeutic procedure for patients with chronic unilateral hematuria.