Transurethral resection of ureteral tumors at the intramural segment: A pilot study.

Background: Ureteral tumors are rare and present unique diagnostic and therapeutic challenges. Objective: This study aimed to evaluate the efficacy and safety of transurethral resection (TUR) in treating ureteral tumors located in the intramural segment of the bladder wall. Methods: This retrospective study analyzed the clinical data of 24 patients who underwent TUR for intramural ureteral tumors at Changhai Hospital, Shanghai, China, from May 2020 to September 2023. All patients were treated using an "outer wedge, inner rotation" technique, with ureteral stent placed during the procedure. Results: All surgeries were successfully completed, with a median operative time of 45 min (range: 25-75 min), median intraoperative blood loss of 5 mL (range: 1-30 mL), median post-operative hospitalization of 4 days (range: 3-10 days), mean ureteral stent placement duration of 34.1 ± 10.1 days, and a mean tumor resection diameter of 1.9 ± 0.7 cm. There were no intraoperative complications, while post-operative hydronephrosis occurred in 12.5% of patients. Pathological examination revealed that all tumors were urothelial carcinoma, with five cases of Ta stage, one case of pT1 low-grade, 14 cases of pT1 high-grade, and four cases of pT2a high-grade. The median follow-up period lasted for 28 months (range: 11-38 months), with a tumor recurrence rate of 20.8%. Conclusion: TUR of ureteral tumors in the intramural segment is a minimally invasive procedure associated with low blood loss, reduced post-operative complications, and efficacious tumor control while preserving renal function. However, the possibility of local tumor recurrence remains, necessitating close post-operative surveillance.