Ureteral retrograde brush biopsy cytology

Definition

Ureteral retrograde brush biopsy cytology is a diagnostic procedure in which tissue from the kidney or ureter (tube that connects a kidney to the bladder) is removed for examination.

Alternative Names

How the test is performed

This procedure is performed using regional (spinal) or general anesthesia. The test takes about 30 to 60 minutes.

A long, thin tube (cystoscope) is first placed through the urethra into the bladder. Then a guide wire is inserted through the cystoscope and into the ureter (the tube between the bladder and kidney).

The cystoscope is removed, leaving the guide wire in place. A small camera used to see the inside of the ureter and kidney (ureteroscope) is then inserted over or next to the guide wire.

A nylon or steel brush is placed through the ureteroscope, and the questionable lesion is rubbed with the brush. Biopsy forceps may be used instead to collect a tissue sample. The brush or biopsy forceps is removed, and the tissue is taken from the instrument and sent to a pathology laboratory for analysis. The instrument and guide wire are completely removed from the body.

How to prepare for the test

Fasting for about 6 hours is generally recommended. Your health care provider will advise you on specific preparations you will need to make.

How the test will feel

After the test is over, you may have some mild cramping or discomfort. Some burning may occur the first few times you empty your bladder. You may also see some blood in your urine for a few days after the procedure.

Why the test is performed

This test is used to obtain a sample of tissue from the kidney (renal pelvis or calyx) or ureter when an x-ray or other test has shown a suspicious area (lesion) or there are suspicious cells in the urine.

Normal Values

The tissue appears normal.

What abnormal results mean

Abnormal results may show cancerous ( carcinoma) cells. This test is often used to differentiate malignant (cancerous) and benign lesions.

What the risks are

• Allergy to iodine-based contrast agent. Inform your health care provider if you have any allergies to seafood, as these may cause allergic reactions to the contrast agent.
• Allergy to anesthetic
• Bleeding
• Infection (urinary tract infection, pyelonephritis, or sepsis)
• Hole (perforation) in the ureter

Special considerations

This test should not be performed in people with acute urinary tract infection or obstruction at or below the biopsy site.

After the test, watch for abdominal pain or flank pain. Excessive pain, fever, or chills should be reported immediately to your health care provider.

A small amount of blood in the urine is normal the first few times you urinate after the procedure. Your urine may look faintly pink. Grossly bloody urine or bleeding that lasts longer than 3 voidings of the bladder should be reported to your health care provider.