Ureteral retrograde brush biopsy
Ureteral retrograde brush biopsy is a procedure in which tissue from the kidney or ureter (tube that connects a kidney to the bladder) is removed for examination.
Biopsy - brush - urinary tract; Retrograde ureteral brush biopsy cytology; Cytology - ureteral regrograde brush biopsy
How the Test is Performed
This procedure is performed using regional (spinal) or general anesthesia. The test takes about 30 - 60 minutes.
A long, thin tube (cystoscope) is first placed through the urethra into the bladder. Then a guide wire is inserted through the cystoscope into the ureter (the tube between the bladder and kidney).
The cystoscope is removed, leaving the guide wire in place. A small camera used to see the inside of the ureter and kidney (ureteroscope) is then inserted over or next to the guide wire.
A nylon or steel brush is placed through the ureteroscope. The suspicious area is rubbed with the brush. Biopsy forceps may be used instead to collect a tissue sample.
The brush or biopsy forceps is removed. The tissue is taken from the instrument and sent to a pathology laboratory for analysis. The instrument and guide wire are completely removed from the body.
How to Prepare for the Test
Fasting for about 6 hours is generally recommended. Your health care provider will advise you on specific preparations you will need to make.
How the Test Will Feel
After the test is over, you may have some mild cramping or discomfort. Some burning may occur the first few times you empty your bladder. You may also see some blood in your urine for a few days after the procedure.
Why the Test is Performed
This test is used to take a sample of tissue from the kidney (renal pelvis or calyx) or ureter. It is performed when an x-ray or other test has shown a suspicious area (lesion), or there are suspicious cells in the urine.
The tissue appears normal.
What Abnormal Results Mean
- Allergy to anesthetic
- Infection (urinary tract infection, pyelonephritis, or sepsis)
- Hole (perforation) in the ureter
Tell your health care provider if you have any allergies to seafood, as these may cause allergic reactions if the contrast dye used during this test is given through a vein (intravenous line).
This test should not be performed in people with acute urinary tract infection or a blockage at or below the biopsy site.
A small amount of blood in the urine is normal the first few times you urinate after the procedure. Your urine may look faintly pink. Report very bloody urine or bleeding that lasts longer than three emptyings of the bladder to your health care provider.
Sagalowsky AI, Jarrett TW. Management of urothelial tumors of the renal pelvis and ureter. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 49.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Louis S. Liou, MD, PhD, Assistant Professor of Urology, Department of Surgery, Boston University School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.