The role of percutaneous nephrostomy in malignant ureteric obstruction

Wilson, Jonathan; Urwin, G. H.; Stower, Michael J.

doi:10.1308/1478708051432

Cited by 81 publications

(71 citation statements)

References 4 publications

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“…Mean of 16.8 days are required for serum biochemical values to reach their nadir levels following PCN insertion [4] as done in our study. On comparision of the pre and post procedure mean parenchymal thickness no statistically significant improvement (increase) was found.…”

Section: Effectivenessmentioning

confidence: 86%

“…Malignant ureteral obstruction is a urologic emergency and if not relieved, the clinical condition deteriorates rapidly due to increasing uremia and associated electrolyte imbalance finally leading to death [1][2][3][4]. Drainage of the obstructed system externally by percutaneous nephrostomy (PCN) or internally by retrograde ureteric stenting provides palliative relief from obstruction which tends to progress despite the treatment of the primary malignancy.…”

Section: Introductionmentioning

confidence: 99%

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Success, Effectiveness and Safety of Combined Sonographic and Fluoroscopic Guided Percutaneous Nephrostomy in Malignant Ureteral Obstruction

Bhatt

Verma

Grover

et al. 2017

IJRRT

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Introduction: Percutaneous nephrostomy (PCN) is a palliative procedure required to drain malignant ureteral obstruction to provide reasonable benefit to the patient. The study was conducted with the objective to assess the success, effectiveness and safety of combined USG and Fluoroscopy guided percutaneous nephrostomy in malignant ureteral obstruction.Method: 69 obstructed ureters due to malignant cause in 50 patients were drained by PCN using combined ultrasound (USG) and fluoroscopic guidance. Postprocedural renal function tests were compared to pre-procedural values using paired t-test. Percentage of correct placement of tube and complications were studied.Result: PCN was successful in 98.55% units. Significant improvement in renal function occurred in 88% patients. Mean urea dropped from 89.68mg/dl ±39.95 to 65.34±16.55 mg/d and mean S. creatinine decreased from 4.31±2.84 to 2.61±1.21 between 14-35 days. No statistically significant increase was seen in renal parenchymal thickness. Major complications developed in 4.33% while minor in 50.72% PCN's with pain being the most common complication in 17.39% cases. Conclusion:PCN was successfully performed under combined image guidance and it effectively drained the obstructed kidney. It is a safe procedure but has a high minor complication rate leading to patient morbidity.

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Section: Effectivenessmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Success, Effectiveness and Safety of Combined Sonographic and Fluoroscopic Guided Percutaneous Nephrostomy in Malignant Ureteral Obstruction

Bhatt

Verma

Grover

et al. 2017

IJRRT

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“…It has a low failure rate, reduces morbidity, and can be performed under local anesthesia [16]. On the other hand, the tortuous ureter traject induces by neoplastic process and locoregional invasion reduces the success rates of the ureteral catheter [16,17] The use of bilateral ureterostomy is exceptional in the literature [18]. The prognosis also differs according to etiology.…”

Section: Discussionmentioning

confidence: 99%

“…Neoplastic anuria is often with poor prognosis (7.14% of mortality). The factors involved are chronic renal failure and the advanced nature of the underlying disease [5,18].…”

Section: Discussionmentioning

confidence: 99%

Obstructive Anuria of Adults in the Region of Eastern Morocco: Epidemiological, Diagnosis and Therapeutic Aspects. Retrospective Two Center Study of 44 Cases

Khalil¹

2017

UNOAJ

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Purpose: To analyze the aspects of obstructive anuria in adults. Materials and Methods:A two center retrospective study over a period of 4 years (2011)(2012)(2013)(2014) compiled 44 patients in two urology departments in the region of eastern Morocco. Many data were collected. We studied two groups: the first group of stone formers patients (n= 16) and the second group of neoplastic patients (n= 28). A comparison between the two groups was performed. Results:The mean age was 61 years with a sex ratio of 1.3. The main symptoms were anuria (50%) and back pain (50%). The obstruction was neoplastic in 28 cases, and 16 cases of stones. A renal urine diversion performed in 11 patients (25%), either by percutaneous nephrostomy in 26 cases (59.1%) or by a double-J ureteral probe in 13 cases (29.5%). There was 3 deaths (6.8%) and 9 cases of chronic renal failure (20.45%).Discussion: To our knowledge, this is the first epidemiological and analytical study on obstructive anuria carried out in the region of eastern Morocco. Urgent diagnosis and therapeutic management are requested to prevent metabolic consequences. Helical CT scan without enhancing contrast is a promising technique for anuria's exploration. It is indicated whenever ultrasonography and standard radiography cannot determine the cause of anuria. Antegrade opacification by the nephrostomy probe and retrograde ureteropyelography (UPR) can be helpful to visualize the nature of the obstacle and its headquarters, but these two examinations are less practiced since the advent of the CT scan. Conclusion:Obstructive anuria is an urological emergency that involves immediate and functional prognosis of the kidney. Its management is closely related to the etiology of the obstruction which also determines the prognosis.

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“…Effective palliation of renal failure is usually achieved by percutaneous nephrostomy, ureteric stent or a combination of both, which are procedures with low morbidity that can improve quality of life. 25 Expandable metallic ureteric stents, extra-anatomic stents and surgical diversion are alternative methods of invasive treatment. Radiotherapy can also reduce the obstruction; however, it is neither as immediate nor effective.…”

Section: Therapeutic Optionsmentioning

confidence: 99%

The changing pattern of management for hormone-refractory, metastatic prostate cancer

James

Bloomfield

Luscombe

2006

Prostate Cancer Prostatic Dis

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Prostate cancer responds initially to hormonal manipulation by androgen withdrawal and peripheral androgen blockade. The inevitable progression to a hormone-refractory state is accompanied by an exacerbation of local symptoms and metastatic spread, principally to the bones, which has a considerable impact on quality of life and survival. Treatment of hormonerefractory prostate cancer is palliative, and surgery and radiotherapy are used for the relief of lower urinary tract symptoms and localized painful bony metastases. Systemic treatments are not widely accepted in this setting, but clinical trials have demonstrated the potential for bone targeting agents such as strontium-89 and the bisphosphonates to palliate painful bone metastases and to delay progression in certain settings. Chemotherapy with mitozantrone in combination with steroids has previously been shown to have palliative benefits and to delay progression. The additional costs incurred by the use of chemotherapy or bone-targeting therapies may be offset by gains in overall care with fewer in-patient admissions compared with steroid monotherapy . Recent clinical trials have demonstrated that docetaxel significantly improves patient quality of life, and importantly, increases survival. Future studies investigating the timing of chemotherapy, combinations with existing treatments or other novel therapies are underway.

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The role of percutaneous nephrostomy in malignant ureteric obstruction

Cited by 81 publications

References 4 publications

Success, Effectiveness and Safety of Combined Sonographic and Fluoroscopic Guided Percutaneous Nephrostomy in Malignant Ureteral Obstruction

Success, Effectiveness and Safety of Combined Sonographic and Fluoroscopic Guided Percutaneous Nephrostomy in Malignant Ureteral Obstruction

Obstructive Anuria of Adults in the Region of Eastern Morocco: Epidemiological, Diagnosis and Therapeutic Aspects. Retrospective Two Center Study of 44 Cases

The changing pattern of management for hormone-refractory, metastatic prostate cancer

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