Impact of palliative urinary diversion by percutaneous nephrostomy drainage and ureteral stenting among patients with advanced cervical cancer and obstructive uropathy: A prospective cohort

2011 ◽  
Vol 37 (8) ◽  
pp. 1061-1070 ◽  
Author(s):  
Marie Carmela M. Lapitan ◽  
Brian S. Buckley
Keyword(s):  
Cervical Cancer ◽  
Urinary Diversion ◽  
Prospective Cohort ◽  
Obstructive Uropathy ◽  
Percutaneous Nephrostomy ◽  
Advanced Cervical Cancer ◽  
Palliative Urinary Diversion ◽  
Ureteral Stenting

scholarly journals Percutaneous nephrostomy versus retrograde ureteral stenting for acute upper obstructive uropathy: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ismail Zul Khairul Azwadi ◽  
Mohd Noor Norhayati ◽  
Mohd Shafie Abdullah
Keyword(s):  
Quality Of Life ◽  
Clinical Trials ◽  
Obstructive Uropathy ◽  
Meta Analysis ◽  
Percutaneous Nephrostomy ◽  
Procedural Pain ◽  
Controlled Trials ◽  
Failure Rates ◽  
Ureteral Stenting

AbstractAcute obstructive uropathy is associated with significant morbidity among patients with any condition that leads to urinary tract obstruction. Immediate urinary diversion is necessary to prevent further damage to the kidneys. In many centres, the two main treatment options include percutaneous nephrostomy (PCN) and retrograde ureteral stenting (RUS). The purpose of this study if to compare the efficacy and safety of PCN and RUS for the treatment of acute obstructive uropathy. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL, EMBASE, the World Health Organisation International Clinical Trials Registry Platform and ClinicalTrials.gov. We also searched the reference lists of included studies to identify any additional trials. We included randomised controlled trials and controlled clinical trials comparing the outcomes of clinical improvement (septic parameters), hospitalisation duration, quality of life, urinary-related symptoms, failure rates, post-procedural pain [measured using a visual analogue scale (VAS)] and analgesics use. We conducted statistical analyses using random effects models and expressed the results as risk ratio (RR) and risk difference (RD) for dichotomous outcomes and mean difference (MD) for continuous outcomes, with 95% confidence intervals (CIs). Seven trials were identified that included 667 patients. Meta-analysis of the data revealed no difference in the two methods in improvement of septic parameters, quality of life, failure rates, post-procedural pain (VAS), or analgesics use. Patients receiving PCN had lower rates of haematuria and dysuria post-operatively and longer hospitalisation duration than those receiving RUS. PCN and RUS are effective for the decompression of an obstructed urinary system, with no significant difference in most outcomes. However, PCN is preferable to RUS because of its reduced impact on the patient’s post-operative quality of life due to haematuria and dysuria, although it is associated with slightly longer hospitalisation duration.

A prognostic model for survival after urinary diversion for malignant ureteral obstruction: A prospective study of 208 patients.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 102-102 ◽  
Author(s):  
Mauricio Cordeiro ◽  
Rafael Coelho ◽  
Rodrigo Rodrigues Pessoa ◽  
Daher Cesar Chade ◽  
Giuliano Betuni Guglielmetti ◽  
...  
Keyword(s):  
Urinary Diversion ◽  
Median Survival ◽  
Obstructive Uropathy ◽  
Tertiary Care ◽  
Multivariable Analysis ◽  
Percutaneous Nephrostomy ◽  
Urinary Obstruction ◽  
University Hospitals ◽  
Imaging Results ◽  
A Prospective Study

102 Background: To determine prognostic factors and create a model for risk stratification in patients with malignant obstructive uropathy. Methods: We prospectively collected clinical and laboratory variables of 208 patients who underwent palliative urinary diversion by ureteral stenting or percutaneous nephrostomy between January 2009 and November 2011 in two tertiary care university hospitals, with minimum 6 months follow-up. Inclusion criteria were age>18yr and malignant urinary obstruction confirmed by computed tomography, ultrasound or magnetic resonance imaging. Results: Median survival after urinary diversion was 144 days. At the end of the study 164 patients died, 44 (21.2%) during the urinary diversion hospitalization. There was no difference in overall survival between the 2 types of diversion (p=0.216). The number of events related to malignant dissemination (≥4) and ECOG index≥2 were associated with shorter survival in multivariable analysis. Using these 2 risk factors (RF), patients were divided into 3 groups: favorable(no RF), intermediate(1RF) and unfavorable(2RF). The median survival at 1, 6, and 12 months was 94.4%, 57.3% and 44.9% in the favorable group, 78.0%, 36.3%, and 15.5% in the intermediate, and 46.4%, 14.3%, and 7.1% in the unfavorable. There were differences in survival profiles of the 3 groups (p<0.001). Conclusions: Our stratification model may be useful tool to determine whether urinary diversion procedures are indicated in patients with malignant urinary obstruction.

scholarly journals Survival outcomes of patients with cervical cancer and accompanying hydronephrosis: A systematic review of the literature

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Vasilios Pergialiotis ◽  
Ioannis Bellos ◽  
Nikolaos Thomakos ◽  
Dimitrios Haidopoulos ◽  
Despina N. Perrea ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Obstructive Uropathy ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Percutaneous Nephrostomy ◽  
Future Research ◽  
Cochrane Central Register ◽  
Central Register ◽  
Present Systematic Review

Hydronephrosis is a sign of advanced stage disease in patients with cervical cancer. Its presence is believed to negatively affect the survival of patients. To date, however, consensus in this field is still lacking. The purpose of the present systematic review is to gather the available data and to provide directions for future research in the field. We systematically searched Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRA and Google Scholar databases from inception till June 2018. Overall, 22 studies were included in the present systematic review that evaluated outcomes from 8521 patients with cervical cancer. The findings of our systematic review support that hydronephrosis negatively affects the overall survival of cervical cancer patients. Specifically, the reported 5-year OS hazards ratio for hydronephrosis ranged between 1.34 and 3.74. Outcomes concerning the disease-free survival of these patients were, however, less discrete. None of the included studies reported whether the decreased survival of patients with hydronephrosis was attributed to complications of obstructive uropathy such as uremia and sepsis. Thus, it remains, to date, unclear whether placement of ureteral stents or percutaneous nephrostomy may actually benefit these patients. More studies are needed to evaluate the actual impact of hydronephrosis on survival rates at the various stages of cervical cancer and to help establish consensus regarding the optimal mode of management of these patients.

scholarly journals Percutaneous Nephrostomy Versus Retrograde Ureteral Stenting for Acute Obstructive Uropathy: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
ZUL KHAIRUL AZWADI ISMAIL ◽  
NORHAYATI MOHD NOOR ◽  
MOHD SHAFIE ABDULLAH
Keyword(s):  
Quality Of Life ◽  
Clinical Trials ◽  
Obstructive Uropathy ◽  
Meta Analysis ◽  
Percutaneous Nephrostomy ◽  
Procedural Pain ◽  
Controlled Trials ◽  
Failure Rates ◽  
Ureteral Stenting

Abstract Acute obstructive uropathy is associated with significant morbidity among patients with any condition that leads to urinary tract obstruction. Immediate urinary diversion is necessary to prevent further damage to the kidneys. In many centres, the two main treatment options include percutaneous nephrostomy (PCN) and retrograde ureteral stenting (RUS). The purpose of this study if to compare the efficacy and safety of PCN and RUS for the treatment of acute obstructive uropathy. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL, EMBASE, the World Health Organisation International Clinical Trials Registry Platform and ClinicalTrials.gov. We also searched the reference lists of included studies to identify any additional trials. We included randomised controlled trials and controlled clinical trials comparing the outcomes of clinical improvement (septic parameters and hospitalisation duration), quality of life, urinary-related symptoms, failure rates, post-procedural pain [measured using a visual analogue scale (VAS)] and analgesics use. We conducted statistical analyses using random effects models and expressed the results as risk ratio (RR) and risk difference (RD) for dichotomous outcomes and mean difference (MD) for continuous outcomes, with 95% confidence intervals (CIs). Seven trials were identified that included 667 patients. Meta-analysis of the data revealed no difference in the two methods in improvement of septic parameters, quality of life, failure rates, post-procedural pain (VAS), or analgesics use. Patients receiving PCN had lower rates of haematuria and dysuria post-operatively and longer hospitalisation duration than those receiving RUS. PCN and RUS are effective for the decompression of an obstructed urinary system, with no significant difference in most outcomes. However, PCN is preferable to RUS because of its reduced impact on the patient’s post-operative quality of life due to haematuria and dysuria, although it is associated with slightly longer hospitalisation duration.

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