A qualitative study exploring male cancer patients’ experiences with percutaneous nephrostomy

Abstract

The study describes how nephrostomy is a burdensome intervention accompanied by a plethora of complex physical and psychosocial issues. Having a nephrostomy on a palliative indication has extensive implications for the patients, which should not be neglected or underestimated. Individual assessment of each patient, together with excellent communication regarding the procedure and outcome, is essential. Most patients had frequent contact with the healthcare system and additional support could be offered by a palliative care service.

Pelvic exenteration surgery in patients with locally advanced castration‐naïve and castration‐resistant, symptomatic prostate cancer

“…Our results are in line with previous studies which demonstrated that neither ADT nor chemotherapy can achieve adequate palliation for the management of locally progressing and symptomatic prostate cancer [23][24][25]. Leibovici et al [24] treated 38 patients with locally advanced primary or recurrent disease by cystoprostatectomy, which led to significant and permanent reduction of symptoms in 30 patients (88.2%).…”

Role of percutaneous nephrostomy in end of life prostate cancer patients: a systematic review of the literature

“…Four studies stated median survival post-PCN that ranged between 4–21 months [9, 11, 14, 15]. The other three studies stated their mean survival time as 31, 4.4 and 15 months respectively [5, 12, 13].…”

“…Malik et al briefly mention a complication rate of 4–26%, which was the same in bilateral and unilateral insertion, but did not document what these complications were [13]. Of the other 3 studies, two did not document any complications [9, 12] and one reported no complications post-PCN [14].…”

“…The readmission rate was only documented in 2 studies. One study [9] just stated that 'multiple' readmissions were made, while the other had almost half of their patient cohort re-admitted [15]. Dowling et al also documented on the proportion of post-PCN life that their patients stayed in hospital.…”

“…The limited life expectancy highlights the importance of maintaining their quality of life (QOL) in this difficult period. Percutaneous nephrostomies can be associated with complications such as skin excoriation, urine leakage, tube dislodgement/displacement/blockage, recurrent infections, haematuria, need for multiple readmissions and reinsertions, and the presence of a nephrostomy bag for urine drainage [9]. In some cases, patient will have bilateral nephrostomies, potentially in addition to a urethral catheter, meaning they have two or three drainage bags to manage, thus impacting significantly on their QOL.…”