Ureteral Stent and Percutaneous Nephrostomy in Managing Malignant Ureteric Obstruction of Gastrointestinal Origin: A 10 Years’ Experience

Background: Malignant ureteral obstruction (MUO) is variable in presentation and there is no consensus on its management, especially when caused by gastrointestinal (GI) malignancies. Our aim was to describe our experience with this oncological complication. Methods: We retrospectively analyzed the outcomes of ureteral stent and nephrostomy tube (NT) positioning for GI-related MUO from 2010 to 2020. We performed descriptive analysis, survival analysis, and uni- and multi-variate analysis. Results: We included 51 patients. NT was mainly used when bladder involvement occurred and when MUO revealed an ex novo cancer diagnosis. Survival was poorer in patients with new diagnoses and in those receiving no treatment after decompression. Moreover, MUO caused by upper-GI tumors was related to shorter overall survival. Conclusions: GI tumors causing MUO should be considered of poor prognosis. Treatment decisions should be weighted accurately by both specialists and the patient.

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Comparative Evaluation of Nonprocedural Nephrostomy-Related Complications in Patients with Ureteric Obstruction due to Cancer versus Other Causes: Is the Protocol of Routine 3-month Nephrostomy Exchange Optimal for Both Disease Processes?

Journal of Clinical Interventional Radiology ISVIR ◽

10.1055/s-0038-1641674 ◽

2018 ◽

Vol 02 (01) ◽

pp. 023-026

Author(s):

Tianshen Hu ◽

Ning Zhang ◽

Joseph Mcdevitt ◽

Ayobami Odu ◽

Yin Xi ◽

...

Keyword(s):

Ureteral Obstruction ◽

Comparative Evaluation ◽

Percutaneous Nephrostomy ◽

Optimal Timing ◽

Ureteric Obstruction ◽

Nephrostomy Tube ◽

Tube Obstruction ◽

Malignant Ureteral Obstruction ◽

A Prospective Study ◽

Made In

Abstract Purpose To evaluate nonprocedural percutaneous nephrostomy (PCN) complications and assess whether the protocol of routine 3-month exchange of PCN is optimal in patients with malignant ureteral obstruction (MUO) and benign ureteral obstruction (BUO). Materials and Methods Retrospective study of 103 patients with a mean age of 48 years (36 men, 67 women) who underwent PCN placement and subsequent PCN exchanges between January 2011 and January 2014 at the institution was conducted. Comparisons of the number of catheter days for those with routine exchange and emergency exchange due to tube obstruction, infection, and mechanical failures were made in patients with MUO and BUO. Results Of the 256 PCN exchange procedures, 139 were performed in the cancer cohort and 117 in the noncancer cohort. Complications requiring emergent exchanges were more common in cancer patients, particularly due to obstruction, which accounted for 57% of exchanges in MUO with a median onset of 50 days. In contrast, the majority of noncancer patients in this study did not require emergent exchange before 3 months. Routine exchanges accounted for 43% and 55% of exchanges in MUO and BUO, respectively. In both the groups, only a small proportion of emergent tube exchanges occurred beyond 105 days. Conclusion A routine 3-month nephrostomy exchange protocol may not be ideal for all patients. The optimal timing for exchange of nephrostomy appears to be earlier for patients with MUO compared with those with BUO. A prospective study is required to define an optimal policy for postprocedural nephrostomy tube care in both the cohorts.

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Survival following palliative percutaneous nephrostomy tube insertion in patients with malignant ureteric obstruction: Validating a prognostic model

Progress in Palliative Care ◽

10.1080/09699260.2021.1905145 ◽

2021 ◽

pp. 1-8

Author(s):

Ben Gunawan ◽

Karyn Foster ◽

Janet Hardy ◽

Phillip Good

Keyword(s):

Prognostic Model ◽

Percutaneous Nephrostomy ◽

Ureteric Obstruction ◽

Nephrostomy Tube ◽

Tube Insertion

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Parallel Second Stent Placement for Refractory Ureteral Stent Malfunction in Malignant Ureteral Obstruction

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2011.02.038 ◽

2011 ◽

Vol 22 (7) ◽

pp. 1012-1016 ◽

Cited By ~ 11

Author(s):

Hung-Chieh Chen ◽

Shu-Huei Shen ◽

Jia-Hwia Wang ◽

William J.S. Huang ◽

Hsiou-Shan Tseng ◽

...

Keyword(s):

Stent Placement ◽

Ureteral Obstruction ◽

Ureteral Stent ◽

Malignant Ureteral Obstruction

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Transient ureteric obstruction following pelvic floor reconstruction

BMJ Case Reports ◽

10.1136/bcr-2020-238669 ◽

2021 ◽

Vol 14 (5) ◽

pp. e238669

Author(s):

Liam Joseph Beamer ◽

Sarah Neary ◽

Thomas McCormack ◽

David Ankers

Keyword(s):

Pelvic Floor ◽

Kidney Injury ◽

Solitary Kidney ◽

Percutaneous Nephrostomy ◽

Pelvic Organ ◽

Ureteric Obstruction ◽

Pelvic Floor Reconstruction ◽

Transient Nature ◽

Recurrent Pelvic Organ Prolapse ◽

History Of

We describe the first reported case of transient distal ureteric obstruction attributed to post-surgical oedema in a patient with a solitary kidney. This occurred following combined pelvic floor repair and sacrospinous fixation for recurrent pelvic organ prolapse and manifested clinically as anuria, radiological hydroureter and acute kidney injury in the postoperative period. The transient nature of this obstruction, which was managed by a temporary percutaneous nephrostomy, indicates that it was caused by ureteric compression secondary to soft tissue oedema following surgery. We highlight the importance of this potential complication in females with a history of nephrectomy, unilateral renal tract anomalies or severely diminished renal reserve.

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