[Diagnosis and surgical treatment of primary tumors of the renal pelvis and ureter].

The incidence of primary tumors of the renal pelvis and ureter is progressively increasing; now they account for about 10 per cent of all urothelial tumors with predominance of papillary ones. They metastasize early, most frequently in the liver, the bones and the lung. For a period of 10 years, 46 patients with upper urinary tract tumors of epithelial origin have been examined and treated. In 30 of these patients (65.2 per cent) the cancer was localized in the renal pelvis and in 16 (34.8 per cent) in the ureter. In 40 patients (87 per cent) the initial symptom was hematuria with dull or colic-like pain in the lumbar area. Excretory urography and retrograde ureteropyelography are essential for the exact diagnosis. Treatment should be early and radical--nephrectomy with total ureterectomy and excision of part of the bladder wall near the ureter orifice. Organ-preserving operations are indicated only in cases of single kidney or accompanying disease of the other kidney, which after some time may require its removal.