Cancers of the lining of the kidney's drainage system or the ureter (upper tract urothelial cancers) are treated differently from common kidney cancers. For high-risk tumours, the standard operation is nephroureterectomy (removal of the kidney, the entire ureter and a small cuff of bladder where the ureter enters). The robotic approach allows this to be completed through small incisions in a single operation.
TREATMENTS
Robotic Nephroureterectomy
When Is Nephroureterectomy Recommended?
• High-grade or larger urothelial tumours of the renal pelvis or ureter
• Tumours not suitable for kidney-preserving (endoscopic laser) treatment
• Recurrence after previous endoscopic management
Treatment Options
• Robotic nephroureterectomy: The kidney, ureter and bladder cuff are removed through small incisions, with lymph node removal where indicated.
• Kidney-sparing endoscopic treatment: In selected cases a low grade, low stage and small tumour can be treated with laser via a ureteroscope, preserving the kidney but requires careful ongoing surveillance.
• A single dose of chemotherapy into the bladder after surgery may be used to reduce the chance of later bladder tumours.
Risks and Considerations
All procedures carry risks, which your surgeon will discuss with you in detail. These may include:
• A long-term reduction in kidney function, monitored with blood tests
• New tumours can appear in the bladder in a proportion of patients — surveillance cystoscopy is essential
Recovery at a glance: Usually 2–4 nights in hospital; catheter placement for 1-2 weeks, light activities within two weeks, full activity by 4–6 weeks.
1
Pre-Operative Planning
CT urography, ureteroscopy with biopsy and/or urine cytology confirm the diagnosis, grade and stage, and whether kidney-sparing treatment is appropriate.
2
Robotic Surgery
The kidney, full length of ureter and a bladder cuff are removed robotically with lymph node dissection where indicated.
3
Bladder check
A cystogram (inject of dye through the catheter) may be used to check your bladder has healed before removal of the catheter.
4
Outcome Monitoring
Regular cystoscopy, imaging and kidney function tests continue long term, guided by tumour stage and grade.
Our Approach
