[Endo-urological drainage in urinary outflow obstruction caused by cancer].
OBJECTIVE
To determine indications and results of endourological upper urinary tract drainage in patients with obstruction due to malignancy.


METHODS
Retrospective.


METHODS
University Hospital Groningen.


METHODS
In the period 1987-1992, 57 patients with upper urinary tract obstruction due to cancer were treated primarily with a double-J stent (n = 21) or a percutaneous nephrostomy (n = 36, later replaced by a double-J stent in 13).


RESULTS
Indications were: severe renal failure following bilateral ureteral obstruction due to malignancy (n = 17), or unknown cause (n = 19), to optimise a compromised kidney function before chemotherapy (n = 7), to resolve pain caused by unilateral obstruction (n = 10), or other (n = 4). The tumours originated most often in the cervix uteri, followed by the urinary bladder, the prostate and the corpus uteri. Minor complications occurred in 34 of the 57 patients (60%): transient haematuria (22 x), urgency caused by the distal tip of the double-J catheter (8 x), dislocation (17 x) or obstruction (6 x) of the nephrostomy catheter. Major complications were observed in 5 patients with a double-J stent: sepsis (1 x), catheter break (1 x), ureteral perforation (2 x) and fistulization between the ureter and iliac artery (1 x). Survival after drainage varied from several days to 8 years (mean 23 months). In 5 patients treated with drainage only to prolong survival, survival was 0.5-16 months (mean 7.3).


CONCLUSIONS
Endourological drainage may be applied to patients with localised disease, in whom further therapy holds the promise of prolonged survival. However, in view of the low complication rate, selected patients who are on a palliative course and still have rapidly progressive disease can also benefit from extended life-time after endourological drainage.
Stevens
A
A
Afd. Urologie, Academisch Ziekenhuis, Groningen.
van Driel
M F
MF
Klein
J P
JP
de Ruiter
A J
AJ
Mensink
H J
HJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004322:Drainage / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous; D010386:Pelvic Neoplasms / Q000150:complications* / Q000401:mortality; D012189:Retrospective Studies; D015996:Survival Rate; D014517:Ureteral Obstruction / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D014546:Urinary Catheterization / Q000379:methods*
Endo-urologische drainage bij urineafvloedbelemmering door kanker.