Surveillance of the Upper Tract After Conservative Treatment

Surveillance is essential following endoscopic treatment for upper tract urothelial carcinoma. However unlike lower tract disease, surveillance cannot be performed in an outpatient basis. It is therefore critical to have a multidisciplinary approach to ensure follow-up. Conservative treatment which involves multiple invasive procedures can be cumbersome, for the patient and constant physician–patient dialogue must be maintained. We will outline the optimal approach in explaining to a patient and their families, what surveillance entails. Our surveillance protocol involves flexible cystoscopy, CT or MR urogram, and upper endoscopy in first 3 months. This is followed by repeat ureteroscopy, cytologies, cystoscopies, and imaging in 3–6 month intervals.