Role of Urinary Diversion in Optimization of Patients of Advanced Cervical Cancer with Obstructive Uropathy
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2017, Vol 5, Issue 7
Abstract
Abstract:Ureteral obstruction in advanced cervical carcinoma can result in renal dysfunction or urosepsis which can restrict patients from receiving proper treatment. Objective of our study is to assess the efficacy of urinary diversion (internal or external) in the management of ureteral obstruction secondary to carcinoma cervix and its effect on patient’s quality of life (QOL) after diversion. We retrospectively reviewed the data of the patients with advanced cervical carcinoma who had undergone some urinary diversion procedure for cervical cancer related obstructive uropathy. Improvement of renal function and quality of life was assessed. This study was done in department of urology from January 2011 to February 2017. Out of 54 such patients, urinary diversion was tried initially using double J (DJ) stenting in 47 patients and initial percutaneous nephrostomy (PCN) in 7 patients who had urosepsis. Among 47, placement of stent was successful only in 19 (40.4%) patients. In remaining 28 patients with failed stent placement, PCN was done. Among 19 patients with properly placed stent, functional failure occurred in 6 (31.6%) patients. In our study renal function improvement was evidenced by fall in serum creatinine level from an average of 4.98 mg/dl to 2.33 mg/dl. QOL improvement was seen in 68% of cases. Thus, palliative urinary diversion is effective in patients with obstructive uropathy complicated by advanced cervical malignancy as it results in significant improvement of renal function as well as QOL. Keywords:carcinoma cervix, obstructive uropathy, double J stenting, percutaneous nephrostomy, quality of life.
Authors and Affiliations
Sunirmal Choudhury, Pritesh Jain, Dilip Kumar Pal
Keywords
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