1Bilal Ibrahim,1Gowsikan Jeyakumar, 1Gowsikan Jeyakumar, 1Omar Kouli, 2Rami Hasan, Rami Hasan
1NHS Greater Glasgow and Clyde
Malignant ureteral obstruction (MUO) is caused by advanced urological or non-urological malignancy and is most commonly treated by either percutaneous nephrostomy (PCN) or ureteric stenting. MUO is seen to have globally poor prognosis, and, if not treated, can result in renal dysfunction, urosepsis or even death in patients regardless of intervention type.
No clear guidelines have been developed or are in use for deciding optimal management for urinary diversion with most authors believing this decision should be individualised under the care of a multidisciplinary team.
Material(s) and Method(s):
All patients treated with ER for CMI After preparation of suitable well-experienced iBetween January 2013 and January 2019, eleven patients (4 males and 7 females, mean age: 61.8 years) with dysfunctional 1340 studies were imported from PubMed, EMBASE and Scopus and studies were selected using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Following the removal of duplicate publications, a screening phase conducted by 2 independent authors resulted in 22 studies for data extraction.
MUO is most commonly caused by non-urological cancer and in most cases, is treated with PCN. PCN patients are more likely to have minor complications and ureteric stent patients are more likely to have major complications. Mortality rates and quality of life are globally poor regardless of intervention type and insufficient data is available to accurately assess cost-efficiency. Non-urological cancers have higher mortality and complications but improved quality of life in comparison to urological cancers. Further research is required to stratify these subgroups per intervention type
The Outback re-entry device can be safely and effectively used as a bail-out measure in patients who fail conventional wiring techniques during endovasOverall, MUO has globally poor prognosis but is worse in the non-urological cancer cohort. PCN patients are more likely to have minor complications and less likely to have major complications with further research required to assess cost-efficiency.