Role of Percutaneous Urinary Diversion in Malignant and Benign Obstructive Uropathy

Pappas, Paris; Stravodimos, Konstantinos; Mitropoulos, Dionisios; Kontopoulou, Christina; Haramoglis, S.; Giannopoulou, Myrto; Tzortzis, George; Giannopoulos, Aris

doi:10.1089/end.2000.14.401

“…Multiple studies have shown both stents and nephrostomy tubes are effective methods to restore kidney function after ureteric obstruction. 2,3,10,[16][17][18][19] Advancements in and availabil- There was a trend toward a decreasing percentage in the number of patients presenting with BUO secondary to cervical cancer compared with 1982. It is possible that aggressive screening for cervical cancer over the past 25 years contributed to this observation.…”

mentioning

confidence: 99%

Acute reversible kidney injury secondary to bilateral ureteric Obstruction

Organ¹,

Norman²

2011

cuaj

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Background: Acute reversible kidney injury (ARKI) secondary to bilateral ureteric obstruction (BUO) is a common urological problem. Our goals were to describe the etiology, management and outcomes of such patients identified between 2006 and 2009 and to compare them with a similar historical study published in 1982. Methods: Chart review was performed on 49 patients with AKRI secondary to BUO. ARKI was defined as ≥33% decrease in serum creatinine after intervention. Those with malignant and benign causes of obstruction were identified and management and outcome data were collected. Results: Of these 49 patients, 83% had BUO secondary to malignancy, 28% of these presenting for the first time. Prevalence of bladder cancer was increased (p = 0.04) and cervix trended lower (p = 0.07) compared with the earlier study; prostate cancer was unchanged (p = 0.51). The average survival was 239 days; 90% of patients died within a year after presenting with BUO from a malignant etiology. Compared with the 1982 group, there were trends towards a decrease in the frequency of retroperitoneal fibrosis (p = 0.08) and an increase in bilateral ureteric calculi (p = 0.16) in the benign group. Conclusions: Patients with ARKI secondary to BUO most likely have an underlying malignancy, with almost a third of them being diagnosed for the first time. Prevalence of bladder cancer increased while cervical cancer trended lower. The cause for the former is unclear; the latter may be due to aggressive screening. Prostate cancer remained unchanged despite the widespread implementation of prostate-specific antigen testing. Patients with an underlying malignancy do poorly and those with a newly diagnosed malignancy do worst. Those with ARKI secondary to benign causes did well.

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“…1,[6][7][8][9][10][11][12][13][14] Percutaneous procedures for obstructive uropathy have been applied in our institution during the last 6 years. 15 We report our results in 15 patients with renal allograft obstructive uropathy who were managed primarily and definitively with percutaneous nephrostomy and prolonged ureteral stenting.…”

Section: Introductionmentioning

confidence: 99%

Obstructive Uropathy in the Transplanted Kidney: Definitive Management with Percutaneous Nephrostomy and Prolonged Ureteral Stenting

Pappas¹,

Giannopoulos²,

Stravodimos³

et al. 2001

Journal of Endourology

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“…Multiple studies have shown both stents and nephrostomy tubes are effective methods to restore kidney function after ureteric obstruction. 2,3,10,[16][17][18][19] Advancements in and availabil- acute reversible kidney injury secondary to BUO ity of imaging techniques have led to less invasive diagnosis and treatment of patients with BUO in the 2009 group. There was a trend toward a decreasing percentage in the number of patients presenting with BUO secondary to cervical cancer compared with 1982.…”

mentioning

confidence: 99%

Acute reversible kidney injury secondary to bilateral ureteric obstruction

Organ

¹

,

Norman

²

2013

CUAJ

0

View full text Add to dashboard Cite

Background: Acute reversible kidney injury (ARKI) secondary to bilateral ureteric obstruction (BUO) is a common urological problem. Our goals were to describe the etiology, management and outcomes of such patients identified between 2006 and 2009 and to compare them with a similar historical study published in 1982. Methods: Chart review was performed on 49 patients with AKRI secondary to BUO. ARKI was defined as ≥33% decrease in serum creatinine after intervention. Those with malignant and benign causes of obstruction were identified and management and outcome data were collected. Results: Of these 49 patients, 83% had BUO secondary to malignancy, 28% of these presenting for the first time. Prevalence of bladder cancer was increased (p = 0.04) and cervix trended lower (p = 0.07) compared with the earlier study; prostate cancer was unchanged (p = 0.51). The average survival was 239 days; 90% of patients died within a year after presenting with BUO from a malignant etiology. Compared with the 1982 group, there were trends towards a decrease in the frequency of retroperitoneal fibrosis (p = 0.08) and an increase in bilateral ureteric calculi (p = 0.16) in the benign group. Conclusions: Patients with ARKI secondary to BUO most likely have an underlying malignancy, with almost a third of them being diagnosed for the first time. Prevalence of bladder cancer increased while cervical cancer trended lower. The cause for the former is unclear; the latter may be due to aggressive screening. Prostate cancer remained unchanged despite the widespread implementation of prostate-specific antigen testing. Patients with an underlying malignancy do poorly and those with a newly diagnosed malignancy do worst. Those with ARKI secondary to benign causes did well.

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Role of Percutaneous Urinary Diversion in Malignant and Benign Obstructive Uropathy

Abstract: Percutaneous urinary diversion under radiologic guidance is a safe and effective procedure for patients with obstructive uropathy.

Cited by 28 publications

References 10 publications

Acute reversible kidney injury secondary to bilateral ureteric Obstruction

Acute reversible kidney injury secondary to bilateral ureteric Obstruction

Obstructive Uropathy in the Transplanted Kidney: Definitive Management with Percutaneous Nephrostomy and Prolonged Ureteral Stenting

Acute reversible kidney injury secondary to bilateral ureteric obstruction

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