Current Strategies for Prevention and Management of Stem Cell Transplant-Related Urinary Tract and Voiding Dysfunction

Overview The management of patients with cancer requires anticipation and timely intervention for urologic complications including urinary tract obstruction, cystitis, nephritis, and nephrotoxicity from chemotherapeutic agents. In patients with limited‐stage disease receiving therapy with curative intent, skilled management of urologic complications is crucial for delivering adequate doses of chemotherapy and avoiding dose reductions that may compromise the likelihood of cure. In the metastatic setting, skillful management of urologic complications including urinary obstruction can provide significant palliation of symptoms. This chapter reviews the diagnosis and management of urinary tract obstruction occurring at the level of the ureters, the bladder, and the urethra. Mechanisms of chemotherapy‐ and radiation‐induced cystitis and nephritis and their management are reviewed. Finally, an overview of the most commonly used potentially nephrotoxic therapeutic agents is provided, with an emphasis on diagnosis, treatment, and prevention. In addition to cytotoxic chemotherapy, the nephrotoxicity caused by targeted therapies is discussed, and emerging insights into immune‐related adverse events ( irAE ) that may affect the kidney are reviewed.

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Urologic Complications

Sanford

Abudayyeh

Logothetis

et al. 2017

Holland‐Frei Cancer Medicine

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Urologic Complications Related to Cancer and Its Treatment

Alhalabi¹,

Abudayyeh²,

Tannir³

2022

Holland‐Frei Cancer Medicine

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Overview Urologic complications of cancer itself or its treatment often require timely identification and intervention. In patients with early‐stage disease, skilled multidisciplinary management of urologic complications is critical to ensure optimal renal function and delivery of adequate doses of chemotherapy that do not compromise the likelihood of cure. Similarly, the management of urologic complications such as urinary obstruction in patients with metastatic disease can have a significant impact on the quality of life. Multiple sites of ureteric obstruction, long occlusions, or a tortuous ureter may be indications to proceed directly with percutaneous nephrostomy instead of ureteral stenting. In contrast to urinary obstruction in newly diagnosed prostate cancer that is likely sensitive to androgen deprivation, castrate‐resistant prostate cancer will likely require more permanent relief of obstruction, either by nephrostomy or suprapubic catheter.

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Current Strategies for Prevention and Management of Stem Cell Transplant-Related Urinary Tract and Voiding Dysfunction

Cited by 2 publications

References 96 publications

Urologic Complications

Urologic Complications

Urologic Complications Related to Cancer and Its Treatment

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