Management of upper urinary tract problems after radical cystectomy for urothelial carcinoma: tips and tricks

M.E.M. van 't Hof*, H.M. Bruins, J.G.H. van Roermund

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review


Purpose of review After radical cystectomy (RC) patients are at risk for both benign and malignant problems regarding the upper urinary tract (UUT). This review summarizes the recent literature and provides tips on how to manage problems of the UUT after RC. Recent findings Disease recurrence, kidney stones and ureteroenteric strictures (UES) are common after RC. Endourological techniques can be used to treat low-grade disease recurrence, either with a retrograde or antegrade approach. Treatment success depends on getting access to the UUT and on tumor characteristics; selecting the right approach is key. Kidney stones can be treated endourologically with good results. With use of minimal invasive techniques such as robot cystectomy, a higher incidence of UES is observed. The use of indocyanine green could help to prevent this complication. In case of a stricture, primary reconstruction should be the treatment strategy of choice. After RC, recurrence of the UUT remains a complicated problem. Choice of treatment method should be tailored to the patient and tumor characteristics. Kidney stones after cystectomy can be successfully managed endourological. Robot assisted RC introduced a higher rate of UES, which should be managed by primary revision.
Original languageEnglish
Pages (from-to)570-573
Number of pages4
JournalCurrent Opinion in Urology
Issue number6
Publication statusPublished - 1 Nov 2021


  • bladder cancer
  • cystectomy
  • kidney stones
  • stricture
  • upper urinary tract recurrence

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