[Endoscopic management of bilateral ureteral obstruction after radiotherapy].
OBJECTIVE
It is difficult to stent the obstructed ureters cystoscopically in patients with renal failure caused by radiotherapy for abdominal or pelvic tumors. Commonly draining the kidney with nephrostomy is the only method for the patients. However, external nephrostomy impacts on life quality of the patients. We reported our experience in stenting the obstructed ureters using minimally invasive percutaneous nephrostomy combined with ureteroscopy, and investigated viability of endoscopic treatment for bilateral ureteral strictures following radiotherapy.


METHODS
Indwelling double pigtail stents in ureter by minimally invasive percutaneous nephrostomy combined with ureteroscopy was carried out in 19 patients with bilateral ureteral strictures following radiotherapy. The clinical outcomes including ureteral drainage and renal function were reviewed.


RESULTS
Bilateral retrograde placement of double pigtail stent was performed in 2 cases. Indwelling different size double pigtail stents in unilateral ureters were carried out in 17 cases. The patients were followed-up for 1-24 months. Renal function was improved excellently in 17 cases, with serum creatinine level of 45 micromol/L to 113 micromol/L. Two patients had poor renal function improvement after ureteral stenting and were converted to percutaneous nephrostomy for draining the kidney.


CONCLUSIONS
Indwelling different size double pigtail stents simultaneously in unilateral ureter by minimally invasive percutaneous nephrostomy is safe, simple, and effective in treating bilateral ureteral obstruction following radiotherapy.
Zeng
Guo-Hua
GH
Mini-Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical College, Guangzhou, Guangdong, 510230, P.R.China. gzgyzgh@163.net
Li
Xun
X
Wu
Kai-Jun
KJ
Chen
Wen-Zhong
WZ
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000532:radiotherapy*; D009403:Nephrostomy, Percutaneous; D011878:Radiotherapy / Q000009:adverse effects*; D015607:Stents; D014517:Ureteral Obstruction / Q000628:therapy*