MP48-02 UPFRONT PERCUTANEOUS NEPHROSTOMY IS THE PREFERABLE APPROACH IN MANAGING HYDRONEPHROSIS IN PATIENTS WITH CERVICAL CANCER

You have accessJournal of UrologyReconstruction: Ureteral Reconstruction (Including Pyeloplasty) and Bladder Reconstruction (Including Trauma-Related Fistula) I (MP48)1 May 2024MP48-02 UPFRONT PERCUTANEOUS NEPHROSTOMY IS THE PREFERABLE APPROACH IN MANAGING HYDRONEPHROSIS IN PATIENTS WITH CERVICAL CANCER Lin Wang, Kelsey Corrigan, Thomas Smith, Ann Klopp, and Ouida Lenaine Westney Lin WangLin Wang , Kelsey CorriganKelsey Corrigan , Thomas SmithThomas Smith , Ann KloppAnn Klopp , and Ouida Lenaine WestneyOuida Lenaine Westney View All Author Informationhttps://doi.org/10.1097/01.JU.0001009512.15743.d7.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To determine the optimal approach for the treatment of hydronephrosis in patients with cervical cancer. METHODS: According to FIGO staging system, the presence of hydronephrosis places a patient to stage IIIB. Therefore, we retrospectively studied stage IIIB, IIIC and IV cervical cancer patients diagnosed between 2016 and 2022 at MD Anderson Cancer Center and selected the ones with hydronephrosis. The laterality of hydronephrosis was calculated. The initial treatment with ureteral stent versus percutaneous nephrostomy (PCN) was analyzed. We also investigated the conversion of ureteral stent to PCN. RESULTS: A total of 89 patients were identified, 69 (77.5%) of whom were found to have hydronephrosis. 27 (39.1%) was found on the left, 17 (24.6%) on the right, 25 (36.2%) were found to have bilateral hydronephrosis. 28 patients received upfront PCN (40.6%). 27 patients (39.1%) underwent ureteral stent placement. 14 (20.2%) patients with hydronephrosis did not receive intervention. Of patients treated with stents, 16 (59.3%) were converted to PCN due to stent failure. The interval between stent placement and PCN ranged from 3 to 901 days with a median of 47 days. 8 (11.6%) patients developed vesicovaginal fistula and underwent bilateral PCN for urinary diversion. None of these patients with hydronephrosis received metallic ureteral stents. CONCLUSIONS: The presence of hydronephrosis implies advanced disease. Cervical cancer patients with hydronephrosis frequently fail ureteral stent, resulting in conversion to PCN within a short period of time. Therefore, upfront PCN may be a preferable approach in managing hydronephrosis in this patient population. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e772 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Lin Wang More articles by this author Kelsey Corrigan More articles by this author Thomas Smith More articles by this author Ann Klopp More articles by this author Ouida Lenaine Westney More articles by this author Expand All Advertisement PDF downloadLoading ...