Incision of the ureterovesical junction for endoscopic surveillance of transitional cell cancer of the upper urinary tract.

Ureteroscopy for treatment of upper tract transitional cell cancer is complicated by the need for subsequent outpatient, anesthesia-based, surveillance ureteroscopy to detect recurrent tumors. We report on 2 patients with ureteroscopically treated renal pelvic transitional cell carcinoma in whom the ureteral tunnel was incised. By rendering the ureterovesical junction incompetent, we created a widely patent refluxing ureteral orifice. During the last 2 years we have been able to perform repeatedly office-based flexible surveillance ureteroscopy without fluoroscopy and without oral or parenteral analgesics in both patients.