What is Ureteral Retrograde Brush Biopsy?
A ureteral retrograde brush biopsy, also known as a retrograde hydrodistension, is a minimally invasive procedure used to diagnose and treat conditions related to the lower urinary tract and bladder. During the procedure, a small biopsy brush is inserted through the urethra and passed up through the bladder and into both ureters. This allows for the collection of tissue samples from the lining of the bladder and ureters.
Preparation for a Ureteral Retrograde Brush Biopsy
Before the procedure, the patient is asked to refrain from eating or drinking anything for at least four to six hours. This helps to ensure a sterile biopsy collection and minimizes the risk of contamination.
The patient is also asked to empty their bladder and bowels prior to the procedure. Depending on the type of anesthesia that will be used, the patient may also need to undergo certain tests prior to preparation.
Procedure
During the procedure, the patient is given anesthesia so that they do not feel any pain. The anesthesiologist may also give the patient a medication in order to help relax the bladder.
Once the patient is sedated, a small biopsy brush is passed through the urethra and into the bladder. The brush is then carefully maneuvered through the bladder and up through both ureters. Once the brush is in place, tissue samples are collected and sent for further analysis.
Types of Ureteral Retrograde Brush Biopsy
There are two types of ureteral retrograde brush biopsies that can be performed:
- Flexible ureteroscope biopsy – During this procedure, a flexible ureteroscope is used to collect tissue samples from both ureters.
- Rigid ureteroscope biopsy – During this procedure, a rigid, small scope is used to collect tissue samples from the ureters.
Risks of Ureteral Retrograde Brush Biopsy
Though the procedure is considered minimally invasive, there are a few potential risks associated with a ureteral retrograde brush biopsy. These include:
- Infection
- Bleeding
- Injury to the bladder or ureters
- Tissue damage
When to Consider a Ureteral Retrograde Brush Biopsy?
A ureteral retrograde brush biopsy may be considered as a diagnostic or therapeutic option in cases of bladder or lower urinary tract conditions that require further evaluation or treatment. Examples of such conditions include bladder outlet obstruction, bladder stones, interstitial cystitis, and prostate cancer.
Why Perform a Ureteral Retrograde Brush Biopsy?
A ureteral retrograde brush biopsy can be used to help diagnose and treat a variety of conditions, as well as to rule out certain conditions. It is a minimally invasive procedure, so it carries fewer risks than traditional open surgery. Additionally, since it only requires a small piece of tissue, it can also help to reduce the risk of post-surgical complications.