Antegrade and retrograde endourological techniques. Equipment and methodology

Low grade and stage upper urinary tract tumors may be treated endoscopically by antegrade or retrograde approach. The approach mainly depends on tumor size and site. Generally, retrograde ureteroscopy is used for small size tumors of the ureter and kidney, whereas the antegrade approach is indicated for bigger tumors in the upper ureter or kidney, or those tumors which cannot be adequately managed in a retrograde manner because of their site (lower calyx) or previous urinary diversion. This article presents the techniques of retrograde ureteroscopy and percutaneous antegrade resection, as well as the equipment needed for adequate endoscopic treatment of the upper urinary tract urothelial tumors.