Ureteral tumors

　　The etiology of ureteral tumors is not yet fully understood. Similar to renal pelvis and bladder tumors, various factors such as smoking, coffee consumption, abuse of analgesics, certain special occupations, chronic inflammation, hydronephrosis, calculi, chemotherapy with cyclophosphamide, and heredity are related to the occurrence and development of ureteral tumors. Some studies have found that the risk of ureteral tumors in smokers is higher than that of renal pelvis tumors and bladder tumors, and there is a dose-effect relationship between the amount of smoking and the risk of tumor occurrence; drinking a large amount of coffee also increases the possibility of developing ureteral tumors; long-term use of analgesics such as phenacetin can greatly increase the incidence of ureteral tumors; those engaged in chemical, petrochemical, and plastic industries, who have long-term contact with coal, asphalt, cocaine, and tar, are much more likely to develop ureteral tumors; chronic bacterial infections, urethral calculi, and obstruction are more likely to produce squamous cell carcinoma, while the possibility of adenocarcinoma is much less; cyclophosphamide, as a chemotherapeutic agent, is also considered not only to increase the possibility of bladder tumors but also to increase the possibility of ureteral tumors.

　　Ureteral tumors can easily lead to renal failure, abdominal pain, and other symptoms. Ureteral tumors are serious diseases that threaten patients' lives and health. Therefore, once symptoms are detected, treatment should be sought promptly.

　　Most patients with ureteral tumors have no obvious positive signs, but about 7% show cachexia, which is indicative of advanced cases. About 5% to 15% can feel an enlarged kidney with costovertebral angle tenderness. Reports indicate that 10% to 15% have no clinical symptoms and are discovered incidentally during examinations for other diseases. The early symptoms of ureteral tumors are as follows:

　　1. Hematuria: The most common symptom, accounting for about 75%. It is often intermittent, painless, gross hematuria, and can appear as string-like blood clots, which may worsen after activity and fatigue.

　　2. Pain: About 60% of cases have pain in the affected side of the abdomen, and severe colic can occur when blood clots block the ureter.

　　3. Masses: Cancer masses blocking the ureter can cause renal pelvis hydrops, and an enlarged kidney can be palpated in the abdomen.

　　Intermittent gross hematuria with long strips of blood clots; imaging examination shows ureteral filling defect; urine sediment cell examination is positive or pathologically confirmed as a tumor, which can be diagnosed.

　　Ureteral tumors can be divided into benign and malignant according to their nature. Benign ureteral tumors include polyps, while malignant tumors include transitional cell carcinoma, transitional cell combined with squamous cell carcinoma, mucinous carcinoma, and so on. The age of onset ranges from 20 to 90 years old.

　　Firstly, the presence of blood in urine should be a cause for concern! Early onset is often hidden, with intermittent or continuous painless gross hematuria, which is often the only early symptom of ureteral tumors. In life, when hematuria is accompanied by pain and other symptoms, patients will think of seeing a doctor. However, painless hematuria is often overlooked by many people, which can easily lead to delayed treatment of the condition. If patients are generally healthy, they should go to the hospital in a timely manner to find out the cause. If ureteral tumors are found early, the lesions are relatively superficial, and the 5-year survival rate can reach 80% after surgical treatment. Therefore, early detection is crucial.

　　Secondly, paying attention to physical health examinations is very necessary and should not be overlooked. Ureteral tumors and other urinary tract tumors can be quickly detected under ultrasound, and the early stage of ureteral tumors can be detected through urine tests. Therefore, everyone should pay attention to the annual physical examination and not use busy work as an excuse to avoid it.

　　Urolithiasis is a common disease in northern China. He Dalin introduced that actually the prevention is very simple, that is, to drink more water.

　　To prevent male urinary tract tumors, it is recommended that men over 40 years old should undergo regular physical examinations, such as reproductive and urological health check-ups, and change bad habits. In life, quit smoking, drink less alcohol, stick to a certain amount of exercise every day, and have a reasonable diet can keep the disease away from us.

　　Strengthen labor protection, reduce contact with exogenous carcinogens, drink more water in daily life, which may play a certain preventive role.

　　1. Urinary tract造影 In addition to poor renal imaging or hydronephrosis on the affected side, it is generally difficult to show filling defects in the ureter. But by trying to pass through renal pelvis puncture造影, ureterography, or in combination with high-dose intravenous urinary tract造影, the whole length of the ureter can be imaged. If a certain segment of the ureter does not show good contrast, it often indicates the presence of a ureteral lesion.

　　2. Urine cytology examination After ureteral catheterization, the flushing fluid cytological examination, any found cancer cells are an important clue for the diagnosis of ureteral cancer.

　　3. Cystoscopy If the ureteral catheter mouth is bleeding, and there is no clear lesion in the kidney or renal pelvis, it is helpful to see an protruding tumor at the ureteral orifice occasionally, or find bladder tumor at the same time, which is helpful for the diagnosis of urinary tract tumor.

　　4. Brush biopsy Using a small brush on the ureteral catheter to take a biopsy from the suspicious area, the positive rate can reach 80%.

　　5. Ureteroscopy Direct observation and biopsy under ureteroscopy can make an accurate diagnosis, with a positive rate of up to 90%, but there may be complications such as perforation.

　　After surgery for urinary tract tumor patients, attention should be paid to reasonable diet to avoid recurrence. At the same time, the patient's diet can directly affect the treatment and recovery of the tumor.

　　After surgery for urinary tract tumor patients, the diet should focus on large doses of tonics, such as silkworm chrysalis, kiwi, jujube, mushrooms, truffles, kelp, saury, silver ear, milk, etc. It should be nutritionally balanced and rich, ensuring 'double high' (i.e., high calories and high protein). For example, it is best to drink two cups of milk, eat one egg, and 150 grams of lean meat every day, or use fish or soy products instead. Eating more fresh vegetables can help the body absorb proteins, sugars, and fats.

　　Eat at least 1 to 3 fruits rich in vitamin C every day. A balanced diet can stimulate the secretion of gastric juice, improve the digestive ability of the stomach, and have a regulatory effect on the secretion of the pancreas. Specific attention should be paid to the following aspects:

　　(1) Daily meals should be regular, in proper portions, and eaten in small, frequent meals to reduce the burden on the gastrointestinal tract.

　　(2) Eat more vitamin-rich foods, more green vegetables, and fruits.

　　(3) Adhere to low-fat, high-protein, and easily digestible foods.

　　(4) Food should be fresh and avoid eating moldy or deteriorated food.

　　(5) To maintain smooth defecation, patients with constipation should consume foods rich in fiber and drink some honey every day.

　　(6) The main foods should include: milk, eggs, soy milk, lotus root starch, fruit juice, vegetable juice, minced lean meat, liver puree, etc.

　　For patients with renal pelvic tumors, bed rest is most important. As symptoms improve significantly, the amount of activity can be gradually increased, following the principle of not feeling tired, and gradually recovering to work.

　　Diet should be light and easy to digest according to the patient's taste. It should contain a variety of vitamins, have sufficient calories and appropriate protein, and fat should not be restricted too strictly. In addition, appropriate rest and reasonable nutrition should be maintained, and appropriate medication should be given according to different conditions. At the same time, avoid drinking, using nephrotoxic drugs, and other factors harmful to the kidneys.

　　1. Surgical Treatment：Once a renal pelvic tumor is diagnosed, it should be removed as soon as possible. Currently, the choice of surgical approach is generally abdominal, with better exposure of the surgical field, which can avoid or reduce damage to other adjacent organs, and can be combined with a thoracoabdominal incision when necessary. The renal pedicle vessels should be blocked as soon as possible during surgery to prevent the spread of tumor cells. At the same time, surrounding fat, fascial tissue, and lymph nodes should be resected. The surgical field is then soaked in distilled water for five minutes to eliminate any remaining disseminated cancer cells. For patients with lung metastasis, who are generally in good condition and whose vital organs can tolerate surgery, it is beneficial to remove the primary cancer to alleviate the condition.

　　2. Radiotherapy：The therapeutic effect of radiotherapy on renal pelvic tumors is not yet established. Currently, radiotherapy for patients with renal pelvic tumors is mainly used for: ①For patients with young age, short history, rapid tumor growth, and obvious toxic symptoms, preoperative radiotherapy can reduce the size of the tumor; ②For cases where the tumor has spread to adjacent organs or incomplete tumor resection, postoperative radiotherapy can reduce local recurrence; ③For advanced renal pelvic tumors that cannot be surgically removed, radiotherapy can alleviate pain, hematuria, and toxic symptoms of the tumor.

　　3. Chemotherapy：Chemotherapy has a poor effect on renal pelvic tumors, combined chemotherapy can improve the efficacy, and in recent years, the体外 chemotherapy sensitivity test has certain benefits in screening chemotherapy drugs.

　　4. Hormonal Therapy：Progesterone, testosterone can have a role in alleviating the condition of metastatic renal pelvic tumors.

　　5. Immunotherapy：BCG, transfer factor, immune RNA, interferon, interleukin, etc., have certain effects on preventing recurrence or alleviating the progression of the disease.