# Upper tract access in patients with urinary diversions

## TL;DR

This paper discusses the challenges and techniques for accessing the upper urinary tract in patients who have undergone urinary diversions.

## Contribution

The paper provides a comprehensive review of approaches and tools for upper tract access in patients with urinary diversions.

## Key findings

- Upper tract access in patients with urinary diversions is challenging due to anastomotic strictures and kidney stones.
- Specialized equipment and techniques are required to facilitate upper tract access in these patients.

## Abstract

Urinary tract diversions are a common reconstructive solution for patients with malignant, anatomic or functional pathologies of the lower urinary tract. Although urinary diversions often represent the patient’s best alternative, they are not devoid of complications. Some of these complications, mainly anastomotic strictures and kidney stones, can be managed endoscopically, although upper tract access of such patients is not straightforward, requiring a fundamental understanding of the many types of diversions. In this article we will review the inherent difficulties of accessing the upper tract of patient with different diversions, the different approaches to the upper tract of diverted patients, and the equipment and techniques that can help facilitate upper tract access in diverted patients.