Ureteropyeloscopy

The basic requirement for such a conservative approach is the confirmation of a low-grade UTUC on ureteropyeloscopy with endoscopic biopsy of the UT.[ 3 4 5 6 ] However, recent studies have shown that the accuracy of endoscopic biopsy for UT tumors is not optimal.[ 7 8 ] UT urine cytology has been widely used and plays an essential role to detect UTUC.[ 9 10 11 12 ] There are wide ranges of the sensitivity of UT urine cytology on detecting UTUC in the literature.[ 13 14 15 ] Several studies have shown that high-grade UTUCs are detected quite reliably by UT cytology.[ 14 16 ] On the other hand, the sensitivity of UT cytology for low-grade lesions is poor.[ 16 17 ] A combined endoscopic biopsy and urine cytology approach has been shown to improve the sensitivity of detecting UTUC.[ 18 19 ] The Johns Hopkins Hospital template (JHHT) of reporting urinary cytopathology was proposed recently, and it is a seven-tiered diagnostic system.[ 20 21 ] This template is intended to improve the predictability of indeterminate urine cytology diagnoses.