Urogynecology Expert Forum
Prolonged ureter issue, possible cancer
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Questions in the Urogynecology forum are answered by Bruce Crawford, MD, J. Kyle Mathews, MD, and other medical professionals and experts. Topics covered include overactive bladders, bladder pain, fallen/drooping bladder, bowel urgency, bowel prolapse, cystitis, incontinence, pain with intercourse, rectal prolapse, surgery, urinary urgency, and uterine prolapse.

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Prolonged ureter issue, possible cancer

The case is about my father who first noticed a blood spot After urine in 2011. He promptly went to a doctor who diagnosed it as UTI and prescribed antibiotics...the issue resolved soon but few months later he started seeing blood spot at the end of urine again, the doctor prescribed antibiotics again but this time it didn't resolve after taking prescribed medicines. In early 2012, my father went to another urologist, who ordered CT Scan and ultrasound, After looking at the results he said there is blockage in the ureter and it's highly likely that it's ureteral cancer and also diagnosed hydronephrosis. He strongly advised my father to have the kidney removed. We asked if he can confirm cancer diagnosis with tests, so he ordered a cystoscopy and a urine test - which was negative. After he did the cystoscopy he said that there is no tumor in the bladder but we should still get the kidney removed, we asked the doctor whether he had looked in the ureter, he said no he just did a cystoscopy - which baffles me to this day. So we went to another doctor who did the utereoscopy and said that it's not a tumor but a ureteric stricture - he didn't do the biopsy though, just a visual diagnosis. He also put a ureteric stent in place to address hydronephrosis. Few weeks later, the blood spot after urine went away and a renal analysis showed improvement in kidney function. The doctor went ahead and removed the stent after 6 weeks and advised us to get a laser procedure done to remove the stricture. After about 6 months (in Nov 2012), the blood spot after urine came back, and I asked my father to get the urine test done again to determine if it's cancer...that test came back negative again. The doctor again did a utereoscopy to put a stent in and said that the stricture is bigger & dense now and ureter is almost fully blocked, so my father scheduled a laser surgery to remove the ureteral stricture, which he had last week.
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Please refer your question to the Urology Forum.  J. Kyle Mathews, MD
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The doctor also took a biopsy this time, but since the surgery my dad has constant fever and has been sick. My question is, what are the chances he has ureteral cancer? is the constant fever a bad sign? if it is cancer, how should we proceed next to make the prognosis good?
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J. Kyle Mathews, MD, DVMBlank
Plano Urogynecology Associates
Plano, TX
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