Subcutaneous Pyelovesical Bypass As Replacement for Standard Percutaneous Nephrostomy for Palliative Urinary Diversion: Prospective Evaluation of Patient's Quality of Life

Desgrandchamps, François; Leroux, Stéphane; Ravery, Vincent; Bochereau, Ghislain; Menut, Philippe; Ballanger, P.; Teillac, P.

doi:10.1089/end.2006.0194

Cited by 31 publications

(12 citation statements)

References 8 publications

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“…Investigators have found no dislodgment or encrustation of the diversion tube. Moreover, there may be significant improvement in patients' quality of life (QOL) after placement [18,19] .…”

Section: Introductionmentioning

confidence: 99%

Use of a Segmental Thermoexpandable Metal Alloy Stent in the Management of Malignant Ureteric Obstruction: A Single Centre Experience in the UK

Zaman¹,

Poullis²,

Bach³

et al. 2011

Urol Int

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Introduction: The Memokath 051™ is a semipermanent inert metal alloy ureteric stent which can bridge strictures and, compared to double J stents, causes less bladder irritation and pain, is more resistant to external compression forces and may be more effective in patients with malignant ureteric obstruction. We present our experience with this novel stent in such cases. Methods: All suitable patients referred to us with malignancy-associated ureteric strictures over a 4-year period had ureteric Memokath 051™ stents inserted. Data on aetiology and position of the strictures as well as length of the Memokath stents used and their efficacy and complications were recorded prospectively. Results: 42 ureteric Memokath 051™ stents were inserted in 37 patients (mean age 64 years). 40.5% of strictures were related to gynaecological cancer, 21% to bowel cancer, 14% were post radiation, 14% occurred in prostate cancer patients and 9.5% were found in other cancers. The mean follow-up was 22 months (range 5–60 months). The main complications were stent migrations in 5, urinary tract infections in 3 and blockage of stent due to progressive transitional cell carcinoma of the ureter in 2 cases. Conclusion: Memokath 051™ ureteric stents are safe, effective and durable in the long-term treatment of malignant strictures.

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“…Investigators have found no dislodgment or encrustation of the diversion tube. Moreover, there may be significant improvement in patients' quality of life (QOL) after placement [18,19] .…”

Section: Introductionmentioning

confidence: 99%

Use of a Segmental Thermoexpandable Metal Alloy Stent in the Management of Malignant Ureteric Obstruction: A Single Centre Experience in the UK

Zaman¹,

Poullis²,

Bach³

et al. 2011

Urol Int

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“…A prospective evaluation of their patients' quality using the EORTC QLC-30 questionnaire following insertion of the Detour EAS demonstrated an improvement of the function scale as a result of the elimination of the external percutaneous tube and a parallel worsening of the symptom scale secondary to the progression of disease (http://groups.eortc.be/qol/ questionnaires_qlqc30.htm). Patient ratings of the global quality of life and satisfaction with the urinary diversion were high because of the absence of the percutaneous tube (Desgrandchamps et al, 2007). Other authors have since reported equally excellent results with the Detour EAS (Lloyd et al, 2007;Olsburgh et al, 2007;Burgos et al, 2009).…”

Section: Discussion Of Resultsmentioning

confidence: 98%

Extra-Anatomic Urinary Drainage for Urinary Obstruction

Kimuli¹,

Sciberras²,

Lloyd³

2012

Chronic Kidney Disease

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“…Moreover, the investigators found a significant improvement in patient QOL, as measured by the validated European Organization for the Research and Treatment of Cancer QLQ-C30 scale, After PCN removal and nephro-vesical bypass placement up to 18 months after the procedure. Patients were able to void normally, which can also have significant impact on QOL compared to that with indwelling Foley catheters or wearing diapers at the end of life [22]. In another study, in five patients (17.9%) of 31, the system had to be replaced due to occlusion at a mean follow-up of 10.2 months [23].…”

Section: Discussionmentioning

confidence: 99%

Modified Supine Position for the Management of Malignant Ureteral Obstruction

Harrech¹,

Ghoundale

Zaini³

et al. 2017

UNOAJ

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Introduction: The treatment of ureteral obstruction due to advanced malignancy is a therapeutic challenge. We propose a new position that allows simultaneous transurethral and transrenal access using a combined approach with eventual endoscopic resection.Material and Methods: 24 patients (44 ureters) underwent ureteral repermeabilisation for malignant ureteral obstruction in the modified supine position. The flank is elevated 30 to 45° with regard to horizontal plane and lower limbs are split and bent in a lower position. After a trial of retrograde catheterization, the kidney is punctured. A straight hydrophilic guide wire and a special intrarenal manipulation catheter were used to cross the malignant ureteric stricture. If not a bladder resection was performed in the same position in direction of the wire with fluoroscopic guidance. The guide wire was then advanced into the bladder. The double-pigtail stent was then placed.Results: Mean age was 64.2 years (32-69). Repermeabilisation were possible in 41 (93.1%) of 44 ureters attempted by the procedure. Trigonal resection was necessary in 12 patients. Median length of stenosis was 2.6 cm (1.6-5cm). No abdominal or thoracic organ injuries were reported. Mean operating room time was 53 min (25-120min). Mean hospital stay was three days (2-6 days).After repermeabilisation, serum creatinine levels decreased significantly from a mean 127.3 mg/l (range, 18-706 mg/l) to 16.2 mg/l (range, 5-28mg/l; p < 0.0001). Conclusion:The modified supine position an important alternative to nephrostomy. It might also be useful for the treatment of other pathologies essentially urolithiasis.

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Subcutaneous Pyelovesical Bypass As Replacement for Standard Percutaneous Nephrostomy for Palliative Urinary Diversion: Prospective Evaluation of Patient's Quality of Life

Abstract: The subcutaneous pyelovesical bypass provides a better quality of life than a standard percutaneous nephrostomy tube in terminally ill patients by making them external-tube free.

Cited by 31 publications

References 8 publications

Use of a Segmental Thermoexpandable Metal Alloy Stent in the Management of Malignant Ureteric Obstruction: A Single Centre Experience in the UK

Use of a Segmental Thermoexpandable Metal Alloy Stent in the Management of Malignant Ureteric Obstruction: A Single Centre Experience in the UK

Extra-Anatomic Urinary Drainage for Urinary Obstruction

Modified Supine Position for the Management of Malignant Ureteral Obstruction

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