Original Article. Urinary Tract Desobstruction in Patients with Malignant Neoplasms of the Uterine Cervix

Nikolay H. Kolev 1 , Alexander Vanov 2 , Vladislav R. Dunev 2 , Rumen P. Kotsev 2 , Boyan A. Stoykov 2 , Fahd Al-Shargabi 2 , Strati S. Stratev 2 , Jitian A. Atanasov 2 , Manish Sachdeva 2 , Pencho T. Tonchev 3 , Sergey D. Iliev 3 ,  and Vladimir R. Radev 4
  • 1 Clinic of Urology, University Hospital – Pleven 8a, G. Kochev Blvd. Pleven, 5800, Bulgaria
  • 2 Department of Urology, Medical University – Pleven, Bulgaria
  • 3 Department of Surgery, Medical University – Pleven, Bulgaria
  • 4 Department of Anaesthesiology and Intensive Care, Medical University – Pleven, Bulgaria

Summary

Cancer of the cervix causes internal, external compression or both of the upper urinary tract in 50-60%of patients in advanced stages. Retrograde stenting is the most widely used technique for desobstruction of the upper urinary tract in urology practice. Diversion of urine flow is an alternative, achieved by nephrostomy of one or both kidneys.We studied retrospectively 33 women with upper urinary tract obstruction caused by carcinoma of the uterine cervix operated on between March 2014 and March 2015 in the urology clinic at the University Hospital in Pleven, Bulgaria. Apercutaneous nephrostomy (PNS) was placed in 17 patients, and 11 patients hadaretrograde catheterization with ureteral stent type JJ. Five patients were treated with both methods. Placement ofa JJstent was the first choice procedure for all patients since it providesabetter quality of life. PNSimproves renal function faster than retrograde JJstenting. Therefore, the first method of choice for patients with an untreated primary cervical, uterine cancer is the placement of PNS. Retrograde JJstenting is the method of choice in patients who undergo surgery and radiation therapy withoutarelapse of the disease.

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  • 1. Valerianova Z, Dimitrova N, Vukov M, Atanasov E, editors. Cancer incidence in Bulgaria 2013. Sofia: Paradigma; 2015.

  • 2. Goldfarb RA, Fan Y, Jarosek S, Elliott SP. The burden of chronic ureteral stenting in cervical cancer survivors. Int Braz J Urol. 2016. doi:

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  • 3. Goodwin WE, Casey WC,Woolf W. Percutaneous trocar (needle) nephrostomy in hydronephrosis. J Am Med Assoc. 1955;157:891-4.

  • 4. Zimskind PD, Fetter TR, Wilkerson JL. Clinical use of long-term indwelling silicone rubber ureteral stents inserted cystoscopically. J Urol. 1967;97:840-4.

  • 5. Chitale SV, Scott-Barrett S, Ho ET, Burgess NA. The management of ureteric obstruction secondary to malignant pelvic disease. Clin Radiol. 2002;57:1118-21.

  • 6. Lee SK, Jones HW 3 . rd Prognostic significance of ureteral obstruction in primary cervical cancer. Int J Gynecol Obstet. 1994;44:59-65.

  • 7. Dyer RB, Regan JD, Kavanagh PV, Khatod EG, Chen MY, Zagoria RJ. Percutaneous nephrostomy with extensions of the technique: step by step. Radiographics. 2002;22(3):503-25.

  • 8. Wilson JR, Urwin GH, Stower MJ. The role of percutaneous nephrostomy in malignant ureteric obstruction.Ann RColl Surg Engl. 2005;87(1):21-4.

  • 9. Romero FR, Broglio M, Pires SR, Roca RF, Guibu IA, Perez MD. Indications for percutaneous nephrostomy in patients with obstructive uropathy due to malignant urogenital neoplasias. Int Braz J Urol. 2005;31(2):117-24.

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