Mieke Bus

18 Chapter 2 Abstract Introduction The applicability of urinary biomarkers and optical diagnostics in upper urinary tract car- cinoma (UTUC) are increasingly debated. To receive insight in the opinion of the urologi- cal community involved in this field, a survey was sent out to identify the most promising techniques and understand the need for new diagnostics. Primary objective of this study was to provide an overview of current diagnostics in upper urinary tract urothelial carci- noma. Secondary objectives of this study was to assess the need for additional diagnos- tic techniques in the current diagnostic work-up for UTUC and to assess knowledge of novel techniques Methods An electronic survey was distributed to all participants of the upper urinary tract tumour registration study by the Clinical Research Office of the Endourological Society. Additionally, based on publications, experts in the field were contacted. Analysis was performed on the results overviewed by the survey monkey website. Results In total 81 of the 112 invited individuals responded resulting in a response rate of 72.3%. Most urologists involved in the treatment of upper urinary tract tumours follow the guide- lines in their diagnostic work-up of patients suspected for UTUC. 61.4% of all responders consider current available diagnostic methods insufficient to select patient candidates for conservative renal sparing surgery. According to the responders, digital endoscopes for ret- rograde intrarenal surgery (RIRS) including narrow band imaging (NBI) are best known and most likely to be beneficial compared to all evaluated diagnostic tools currently available. Conclusions Urologists consider current diagnostic techniques for upper urinary tract tumours insuffi- cient for optimal patient selection for conservative renal sparing surgery. Among the new techniques, NBI and digital RIRS are best known and considered to be beneficial in the diagnostic work-up.