Maintaining quality of life after palliative diversion for malignant ureteral obstruction

Abstract

The records of 71 consecutive patients who underwent percutaneous nephrostomy for malignant ureteral obstruction were reviewed. The average post-nephrostomy survival time was seven months, of which 25% was spent in the hospital. When comparing these figures to older studies of open nephrostomy, the percutaneous procedure is associated with less morbidity and an increased percentage of time spent at home (75% compared to 36%). Long-term survival, however, is still poor, with only 25% of patients alive at one year. We suggest that the criteria previously adopted for open nephrostomy generally remain appropriate for patients being considered for percutaneous urinary diversion.

In Vitro Study of Antimicrobial Percutaneous Nephrostomy Catheters for Prevention of Renal Infections

“…Additionally, in the same study, PCN catheter placement and other therapeutic modalities also provided benefits for patients treated for neoplasia (17). The use of PCN catheters has also been shown to increase quality of life at home after urinary diversion procedures are performed (18). However, increased high risk of infection is still a major concern (3).…”

Nephrostomies in obstructive uropathy; how should hormone resistant prostate cancer patients be managed and can we predict who will benefit?

“…The widespread adoption of percutaneous nephrostomy has altered the suitability of patients for decompression in a group whose prognosis is known to be poor. 1,5,6 This is partly due to the reduced complication rate, which ranges from 4 to 26%, 2,5,7 and the relative ease and low cost of the procedure. We were surprised by the fact that we had treated so many more hormone resistant than naive men, but this did allow us to analyse a group of patients who are notoriously difficult to treat.…”

“…In prostate cancer, current opinion suggests that hormone naive patients benefit significantly from a nephrostomy, while the gain for hormone resistant cases is less good. 1,2 There are also no reliable prognostic markers to help in deciding who will derive significant benefit from a nephrostomy. In this study, we aimed to establish the role of urinary tract decompression in prostate cancer, with particular interest in the influence of hormone status and any potential factors that may help predict outcome.…”

Ureteral Reimplantation or Percutaneous Nephrostomy: Which One Is Better in Management of Complete Ureteral Obstruction Due to Advanced Prostate Cancer?

“…Each method has its advantages and disadvantages (13)(14)(15)(16)(17)(18). Complications associated with nephrostomy are reported in 4% to 26 % of procedures (15,19,20). But, in other studies, complication rates exceed for both PCN and ureteral stents (9).…”