Resumen
The diagnosis of primary upper urinary tract urothelial carcinoma is challenging and may necessitate invasive procedures. In this study, through analysing two cohorts, we evaluated the diagnostic accuracy of drug-induced turbulence in the upper urinary tract and non-invasive urine sampling in the diagnosis of primary upper tract urothelial carcinoma and upper tract urothelial carcinoma recurrence during follow-up after radical cystectomy for primary bladder cancer. As a diagnostic tool, cytology of pharmacologically forced diuresis performs better in patients with invasive upper tract urothelial carcinoma and concomitant carcinoma in situ. As a method of surveillance, positive cytology of pharmacologically forced diuresis was related to cancer recurrence and could even detect recurrence in the urethra in cases involving an orthotopic bladder substitute. In conclusion, urine cytology in pharmacologically forced diuresis may be useful in patients with suspected upper tract urothelial carcinoma, especially in cases with contraindications for imaging or when achieving endoscopic access to the upper urinary tract is difficult.