Obstructive Uropathy Treatment Complication Rate after Percutaneous Nephrostomy versus Double J Catheter Insertion

2018 ◽  
Vol 25 (2) ◽  
pp. 46-53
Author(s):  
Mohammad Mousa ◽  
Ashraf Al-Majali ◽  
Firas Al-Hammouri ◽  
Adnan Abo-Qamar ◽  
Samer Aljfoot ◽  
...  
Keyword(s):  
Complication Rate ◽  
Obstructive Uropathy ◽  
Percutaneous Nephrostomy ◽  
Catheter Insertion ◽  
Treatment Complication

scholarly journals Percutaneous nephrostomy versus retrograde ureteral stenting for acute upper obstructive uropathy: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ismail Zul Khairul Azwadi ◽  
Mohd Noor Norhayati ◽  
Mohd Shafie Abdullah
Keyword(s):  
Quality Of Life ◽  
Clinical Trials ◽  
Obstructive Uropathy ◽  
Meta Analysis ◽  
Percutaneous Nephrostomy ◽  
Procedural Pain ◽  
Controlled Trials ◽  
Failure Rates ◽  
Ureteral Stenting

AbstractAcute obstructive uropathy is associated with significant morbidity among patients with any condition that leads to urinary tract obstruction. Immediate urinary diversion is necessary to prevent further damage to the kidneys. In many centres, the two main treatment options include percutaneous nephrostomy (PCN) and retrograde ureteral stenting (RUS). The purpose of this study if to compare the efficacy and safety of PCN and RUS for the treatment of acute obstructive uropathy. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL, EMBASE, the World Health Organisation International Clinical Trials Registry Platform and ClinicalTrials.gov. We also searched the reference lists of included studies to identify any additional trials. We included randomised controlled trials and controlled clinical trials comparing the outcomes of clinical improvement (septic parameters), hospitalisation duration, quality of life, urinary-related symptoms, failure rates, post-procedural pain [measured using a visual analogue scale (VAS)] and analgesics use. We conducted statistical analyses using random effects models and expressed the results as risk ratio (RR) and risk difference (RD) for dichotomous outcomes and mean difference (MD) for continuous outcomes, with 95% confidence intervals (CIs). Seven trials were identified that included 667 patients. Meta-analysis of the data revealed no difference in the two methods in improvement of septic parameters, quality of life, failure rates, post-procedural pain (VAS), or analgesics use. Patients receiving PCN had lower rates of haematuria and dysuria post-operatively and longer hospitalisation duration than those receiving RUS. PCN and RUS are effective for the decompression of an obstructed urinary system, with no significant difference in most outcomes. However, PCN is preferable to RUS because of its reduced impact on the patient’s post-operative quality of life due to haematuria and dysuria, although it is associated with slightly longer hospitalisation duration.

scholarly journals Genitourinary Tuberculosis: A Rare Cause of Obstructive Uropathy in Pregnancy

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Emily H. Adhikari ◽  
Elaine L. Duryea ◽  
Martha W.F. Rac ◽  
Jeanne S. Sheffield
Keyword(s):  
Pregnancy Outcomes ◽  
Early Recognition ◽  
Obstructive Uropathy ◽  
Extrapulmonary Tuberculosis ◽  
Percutaneous Nephrostomy ◽  
Foreign Born ◽  
Imaging Studies ◽  
Genitourinary Tuberculosis ◽  
Prompt Treatment ◽  
In Pregnancy

Background. A rare but morbid form of extrapulmonary tuberculosis (TB), genitourinary TB is an important cause of obstructive uropathy and is likely underdiagnosed in pregnancy.Case. A 30-year-old primigravida undergoing treatment for active pulmonary TB presented with anuria at 13-14-weeks gestation. Bilateral ureteral strictures above the level of the ureterovesicular junctions were seen on imaging studies. Given her pulmonary disease, her obstructive uropathy was attributed to genitourinary TB. Bilateral percutaneous nephrostomy tubes were placed during pregnancy with successful ureteral reimplantation postpartum.Conclusion. Genitourinary TB should be considered as an etiology of urinary tract pathology during pregnancy, especially in foreign-born and immunocompromised persons. Early recognition resulting in prompt treatment can prevent further deterioration of maternal renal function and optimize pregnancy outcomes.

A prognostic model for survival after urinary diversion for malignant ureteral obstruction: A prospective study of 208 patients.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 102-102 ◽  
Author(s):  
Mauricio Cordeiro ◽  
Rafael Coelho ◽  
Rodrigo Rodrigues Pessoa ◽  
Daher Cesar Chade ◽  
Giuliano Betuni Guglielmetti ◽  
...  
Keyword(s):  
Urinary Diversion ◽  
Median Survival ◽  
Obstructive Uropathy ◽  
Tertiary Care ◽  
Multivariable Analysis ◽  
Percutaneous Nephrostomy ◽  
Urinary Obstruction ◽  
University Hospitals ◽  
Imaging Results ◽  
A Prospective Study

102 Background: To determine prognostic factors and create a model for risk stratification in patients with malignant obstructive uropathy. Methods: We prospectively collected clinical and laboratory variables of 208 patients who underwent palliative urinary diversion by ureteral stenting or percutaneous nephrostomy between January 2009 and November 2011 in two tertiary care university hospitals, with minimum 6 months follow-up. Inclusion criteria were age>18yr and malignant urinary obstruction confirmed by computed tomography, ultrasound or magnetic resonance imaging. Results: Median survival after urinary diversion was 144 days. At the end of the study 164 patients died, 44 (21.2%) during the urinary diversion hospitalization. There was no difference in overall survival between the 2 types of diversion (p=0.216). The number of events related to malignant dissemination (≥4) and ECOG index≥2 were associated with shorter survival in multivariable analysis. Using these 2 risk factors (RF), patients were divided into 3 groups: favorable(no RF), intermediate(1RF) and unfavorable(2RF). The median survival at 1, 6, and 12 months was 94.4%, 57.3% and 44.9% in the favorable group, 78.0%, 36.3%, and 15.5% in the intermediate, and 46.4%, 14.3%, and 7.1% in the unfavorable. There were differences in survival profiles of the 3 groups (p<0.001). Conclusions: Our stratification model may be useful tool to determine whether urinary diversion procedures are indicated in patients with malignant urinary obstruction.

Pelvic lipomatosis associated with bilateral obstructive uropathy and proliferative cystitis

2021 ◽  
Vol 14 (8) ◽  
pp. e233428
Author(s):  
Joan Marie Salangsang Flor ◽  
Michael John Francis Velarde Gaston ◽  
Marie Carmela Montillero Lapitan
Keyword(s):  
Bladder Outlet Obstruction ◽  
Clinical Case ◽  
Obstructive Uropathy ◽  
Outlet Obstruction ◽  
Percutaneous Nephrostomy ◽  
Tube Insertion ◽  
Pelvic Lipomatosis ◽  
Increased Risk ◽  
Bladder Adenocarcinoma

Pelvic lipomatosis is a rare benign entity characterised by excessive deposition of adipose tissue in the perirectal and perivesical spaces. We describe a 43-year-old man with bilateral distal ureteral obstruction secondary to pelvic lipomatosis with concomitant proliferative cystitis resulting in severe hydronephrosis. We performed urinary diversion with percutaneous nephrostomy tube insertion to prevent further renal impairment. The patient was advised close follow-up to monitor the increased risk of bladder adenocarcinoma transformation observed in patients with cystitis glandularis. This report, compliant with the CARE (CAse REport) guidelines for clinical case reporting, presents another case of pelvic lipomatosis associated with acute kidney failure, bilateral hydronephrosis and proliferative cystitis without urodynamic evidence of bladder outlet obstruction that may serve to guide urologists in managing patients with a similar profile.

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