[Endoluminal therapy for bilateral malignant ureteric obstruction].
OBJECTIVE
To evaluate the endourological technique in the treatment of bilateral malignant ureteric obstruction.


METHODS
The data of 43 patients (totally, 70 cases) with bilateral malignant ureteric obstruction treated with endoluminal therapy were reviewed retrospectively. Of 70 cases, 38 were treated by retrograde double-J stenting, 24 by minimally invasive percutaneous nephrotomy (MPCN) and 8 by antegrade double-J stenting.


RESULTS
All patients were followed up for an average of 12 months. The retrograde double-J stenting, MPCN and antegrade double-J stenting was successfully performed in 50.0% (19/38), 100.0% (24/24) and 62.5% (5/8), respectively. Technical failures in placing retrograde double-J stent were too difficult to identify the ureteric orifice (13/38) or failing to cross the obstruction site because of severe extraluminal compression (6/38). Failure in placing antegrade double-J stent was due to severe extraluminal compression (3/8). Dislodgment of nephrostomy tubes (11/19) was the major factor which limited the application of MPCN.


CONCLUSIONS
It is safe and effective to treat malignant ureteric obstruction with endourological technique, and suggested initially with retrograde double-J stenting. If malignant ureteric orifice occlusion or a severe extraluminal compression is showed in the imaging, MPCN or antegrade double-J stenting may be selected according to the site and the extent of obstruction.
Liu
Yong-Da
YD
Department of Urology, Minimally Invasive Center, First Affiliated Hospital, Guangzhou Medical College, Guangzhou 510230, China. liuyongda.jinbi@163.com
Yuan
Jian
J
Huang
Shun-Tan
ST
Luo
Jin-Tai
JT
Zeng
Guo-Hua
GH
Xun
Li
L
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D011471:Prostatic Neoplasms / Q000150:complications; D012189:Retrospective Studies; D015607:Stents; D013274:Stomach Neoplasms / Q000150:complications; D017211:Treatment Failure; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000209:etiology / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000150:complications; D002583:Uterine Cervical Neoplasms / Q000150:complications*