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Percutaneous Nephrostomy Versus Indwelling Ureteral Stent in the Management of Gynecological Malignancies
  1. Yan Song, MD,
  2. Xiang Fei, MD and
  3. Yongsheng Song, MD
  1. Urology Division, Sheng Jing Hospital, China Medical University, Shenyang, PR China.
  1. Address correspondence and reprint requests to Yongsheng Song, MD, Urology Division, Sheng Jing Hospital, China Medical University, Shenyang, PR China. E-mail: Alexander-song@163.com.

Abstract

Objectives The aims of this study were to evaluate the efficacy of retrograde ureteral stenting and to identify the predictive factors for potential failure of this technique in women with advanced gynecologic malignancies.

Methods From 2006 to 2010, a retrospective analysis was performed on a total of 75 patients with ureteral obstruction due to gynecologic malignancies. This population was divided into group 1 (n = 50) in which retrograde stent placement was successful, and group 2 (n = 25) in which stent placement failed and subsequent percutaneous nephrostomy tube placement was required. Multivariate analysis was done to identify predictors of the failure of ureteral stent insertion.

Results Multivariate analysis revealed that mean preprocedureal serum cystanin C greater than 2.5 mg/L and length of the ureteral obstruction greater than 3 cm were significant predictors of stent failure. Neither the causes nor location of obstruction predicted the need for percutaneous nephrostomy (PCN). No statistical significance was detected among the subgroups of patients with different degrees of hydronephrosis. Statistical significant differences were found between the 2 groups in procedural time, average cost, and mean interval of stent/catheter replacement. However, no statistically significant difference was found in the median survival time and overall stent-related or catheter-related complications between the 2 groups.

Conclusions Retrograde ureteral stenting is a first-line option for managing ureteral obstruction caused by gynecologic malignancies. However, in cases where the preprocedureal mean serum cystanin C is greater than 2.5 mg/L and the length of the ureteral obstruction segment is greater than 3 cm, these patients may be better served by percutaneous drainage.

  • PCN
  • IUS
  • Gynecologic malignancies

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Footnotes

  • The authors have no conflict of interest.

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