Introduction Cervical cancer is diagnosed 60–70% at an advanced stage in low countries. Hydronephrosis is a common occurrence in patients with advanced cervical cancer (14 to 44%). We aimed to describe the survival in those patients and comfort after urinary diversion.

Methods This is a cross-sectional study during 25-month that included 82 patients with stage IIIB cervical cancer in a public hospital Joseph Ravoahangy Andrianavalona oncology and radiotherapy Department.

Results Thirty-one patients (37%) underwent diversion. Twelve patients (38.7%) had improvement of renal function. Half the patients had improvement in lumbar pain hydronephrosis-related. Complications after diversion was mainly surgical site infection (19%). Median overall survival was for those patients underwent or no urinary diversion was 90 days. The median survival in patients who underwent diversion was 90 days and 60 days whom required diversion but elected not to receive it. The survival with unilateral and bilateral hydronephrosis was 195 days and 75 days. Median survival was 90 days and 60 days for patients with and without chemotherapy after diversion. No patients received radiation because a public centre was not available during the study period due to costs.

Conclusion Hydronephrosis is a predictor of poor survival in patients with advanced stage cervical cancer. Urinary diversion improves the lumbar pain hydronephrosis-related, improve renal function, confers a short-time survival benefit. It could provide conditions for patients receiving treatment for advanced cervical cancer.