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ABSTRACT Objective: It has been reported that phosphodiesterase-5 (PDE-5) inhibitors improve kidney function during acute and chronic renal failure. This study aimed to determine the possible therapeutic effects of tadalafil, a specific PDE-5 inhibitor, on renal fibrosis induced by unilateral ureteral obstruction (UUO). Methods: Male Sprague-Dawley rats were used and randomly divided into three groups (n = 6) as sham-operated, UUO and tadalafil-treated (10 mg/72 hours, ig) UUO (UUO+T) groups. Unilateral ureteral obstruction was induced by complete ligation of the left ureter and 14 days after surgery creatinine clearance, urinary cyclic guanosine monophosphate (cGMP), renal alpha-smooth muscle actin (α-sma) and transforming growth factor βeta (TGF-β) levels, as well as histologic changes, were observed in all the animals. Results: Unilateral ureteral obstruction-induced renal fibrosis was confirmed by increased α-sma level, collagen deposition, tubular dilation, inflammatory cell infiltration and necrosis. An increased renal TGF-β level and decreased urinary cGMP level was also observed in obstructed animals in addition to reduced creatinine clearance. Tadalafil treatment, which restored the animals 'urinary cGMP level, significantly attenuated the fibrotic changes and TGF-β increase in their kidneys. Conclusion: This study suggests that tadalafil treatment ameliorates renal fibrosis by reducing TGF-β expression and may have important clinical relevance since tadalafil is currently used clinically to treat erectile dysfunction and pulmonary hypertension.
RESUMEN Objetivo: Se ha reportado que los inhibidores de la fosfodiesterasa-5 (PDE-5) mejoran las funciones renales durante la insuficiencia renal aguda y crónica. Este estudio tuvo por objetivo determinar los posibles efectos terapéuticos del tadalafil - un inhibidor específico de la PDE-5 - sobre la fibrosis renal inducida por una obstrucción ureteral unilateral (OUU). Métodos: Se utilizaron ratas machos Sprague-Dawley, divididas de manera aleatoria en tres grupos (n = 6): operación simulada, OUU y tratamiento con tadalafil (10 mg/72 horas, IG), y OUU (OUU+T). La obstrucción uretral unilateral fue inducida por una ligadura completa del uréter izquierdo y 14 días después de la cirugía, se observaron niveles de monofosfato de guanosina cíclico (GMP) urinario, alfa-actina de músculo liso (α-SMA), y factor de crecimiento transformante βeta (FCT-β), así como cambios histológicos en todos los animales. Resultados: La fibrosis renal inducida por obstrucción uretral unilateral fue confirmada por un aumento del nivel de α-SMA, deposición de colágeno, dilatación tubular, infiltración de células inflamatorias y necrosis. También se observó un aumento del nivel de FCT-β renal y una disminución del nivel de GMP urinario en los animales con obstrucción, además de una reducción del aclaramiento de la creatinina. El tratamiento con tadalafil, que restauró el nivel de GMP urinario de los animales, atenuó significativamente los cambios fibróticos y el aumento de FCT-β en los riñones. Conclusión: Este estudio sugiere que el tratamiento con tadalafil mejora la fibrosis renal al reducir la expresión de FCT-β y puede tener una importante relevancia clínica por cuanto el tadalafil se usa hoy día clínicamente para tratar la disfunción eréctil y la hipertensión pulmonar.
Subject(s)
Animals , Rats , Renal Agents/pharmacology , Fibromyalgia/drug therapy , Tadalafil/pharmacology , Kidney Diseases/drug therapy , Ureteral Obstruction/complications , Fibromyalgia/etiology , Rats, Sprague-Dawley , Disease Models, Animal , Kidney Diseases/etiologyABSTRACT
Objective To investigate the effect of erythropoietin(EDO)on the expression and function of aqua_porin_1( AQD _1)in the kidney of young male SD rats after release of bilateral ureter obstruction( BUO _ R). Methods Porty_eight young SD rats were randomly divided into bilateral ureteral complete obstruction(BUO)group (n﹦6),BUO_R group(n﹦12),BUO_R﹢EDO group( n﹦12)and Sham group( n﹦18). The BUO model was built through bilateral ureteral ligation. BUO group were killed after 24 h,and BUO_R group and BUO_R﹢EDO group were relieved after obstruction of 24 h. EDO(500 U∕kg)was given to BUO_R﹢EDO rats at 1 h after release of BUO,and then repeated 1 d,3 d and 5 d thereafter and the same volume of 9 g∕L saline was simultaneously given to BUO_R rats. The Sham group was prepared in parallel by laparotomy and free dissection of bilateral ureters but not ligated,both side kidneys and blood samples were collected on 3 d and 7 d(24 h,3 d,7 d for Sham group)after release of BUO. The u_rine samples were collected by using metabolic cage before death. The plasma osmotic pressure,creatinine(Cr)and u_rea nitrogen(BUN)in the plasma of young rats were detected. The expression of AQD_1 protein in all groups of kidney tissues was detected by adopting immunohistochemistry and Western blot. Results On day 3 after release of BUO,24 h water intake and urine volume of BUO_R﹢EDO group were higher than those of Sham group,but lower than those of BUO group(P〈0. 05),the urine osmotic pressure of BUO_R﹢EDO group was higher than that of BUO group,but lower than that of Sham group(P〈0. 05),while plasma osmotic pressure,Cr and BUN of BUO_R﹢EDO group were higher than those of Sham group,but lower than those of BUO group(P〈0. 05),and they were all of lower than BUO group( P 〈0. 05). On day 7 after release of BUO,there was no obvious change in Sham group,and the indexes of BUO_R group and BUO_R﹢EDO group gradually recovered,but they still did not reach the normal level(P〈0. 05). The difference between BUO_R group and BUO_R﹢EDO group was statistically significant(P〈0. 05). The immuno_histochemical results showed that the expression of AQD_1 in collecting duct in BUO group was significantly down_regulated compared with that in Sham group,whereas it was slightly weaker in BUO_R group and BUO_R﹢EDO group than that of Sham group(P〈0. 05). Compared with 3 days after release of BUO,the staining intensity of BUO_R﹢EDO group and BUO_R group was enhanced,but still lower than that of the Sham group. These results were further confirmed by adopting Western blot,and BUO group was also the lowest of the four groups,and BUO_R﹢EDO group was higher than that of BUO group,but lower than that of Sham group( P〈0. 05). Conclusion EDO can promote not only the recovery of AQD_1 protein expression but also the recovery of renal function in young BUO_R rats.
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Objective@#To investigate the effect of erythropoietin (EPO) on the expression of aquaporin 2-3 after the release of unilateral ureter obstruction in young rats.@*Methods@#Twenty-four SD rats were randomly divided into 3 groups(CUUO-R group, CUUO-R+ EPO group and sham group, with 8 rats in each group). The CUUO-R model was built through unilateral ureteral ligation, after 48 h the obstruction was released.EPO was given to the CUUO-R+ EPO group at the time point of removing obstruction, and then repeated every other day for 1 week, and the same volume of saline was simultaneously given to the CUUO-R rats.The rats in sham group experienced the laparotomy and free dissection of left ureter but not ligation.The kidneys were harvested 7 d after the release of CUUO.The methods of Western blot and immunohistochemistry were used to examine the effects of erythropoietin on the expression of AQP2 and AQP3.@*Results@#The osmotic pressure of CUUO-R+ EPO group was higher than those of CUUO-R group, but lower than that of sham group(P=0.007). The concentration of creatinine and urea in the CUUO-R group[(58.001±2.416) μmol/L and (9.025±1.158) mmol/L]were higher than those of CUUO-R+ EPO group [(57.072±2.286) μmol/L and (1.479±0.043) mmol/L] and sham group [(54.820±1.536) μmol/L and (6.929±0.604) mmol/L]. The differences of the concentration of creatinine and urea between CUUO-R group and sham group were statistically significant(P<0.05). There was no significant difference between CUUO-R+ EPO group and Sham group(P>0.05). The immunohistochemistry showed that the expressions of AQP2 and AQP3 in co-llecting duct in CUUO-R group were significantly weaker than those of in sham group, and the expression of those in CUUO-R+ EPO group were slightly weaker than sham group.These results were further confirmed by Western blot, as the relative quantity of AQP2 and AQP3 were also the lowest in CUUO-R group(AQP2 in 3 groups were 0.974±0.109, 1.923±0.097 and 2.002±0.044, F=392.4, P=0.000; AQP3 in 3 groups were 0.941±0.048, 1.497±0.043 and 1.863±0.043, F=735.8, P=0.000).@*Conclusions@#EPO treatment is beneficial for the recovery expre-ssion of AQP2 and AQP3 as well as renal function at the early period after the release of ureteral obstruction in young rats.
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Objective To investigate the effect of erythropoietin (EPO) on the expression of aquaporin 2-3 after the release of unilateral ureter obstruction in young rats.Methods Twenty-four SD rats were randomly divided into 3 groups(CUUO-R group,CUUO-R + EPO group and sham group,with 8 rats in each group).The CUUO-R model was built through unilateral ureteral ligation,after 48 h the obstruction was released.EPO was given to the CUUO-R + EPO group at the time point of removing obstruction,and then repeated every other day for 1 week,and the same volume of saline was simultaneously given to the CUUO-R rats.The rats in sham group experienced the laparotomy and free dissection of left ureter but not ligation.The kidneys were harvested 7 d after the release of CUUO.The methods of Western blot and immunohistochemistry were used to examine the effects of erythropoietin on the expression of AQP2 and AQP3.Results The osmotic pressure of CUUO-R + EPO group was higher than those of CUUO-R group,but lower than that of sham group (P =0.007).The concentration of creatinine and urea in the CUUO-R group [(58.001 ± 2.416) μmol/L and (9.025 ± 1.158) mmol/L] were higher than those of CUUO-R + EPO group [(57.072 ± 2.286) μmol/L and (1.479 ± 0.043) mmol/L] and sham group [(54.820 ± 1.536) μmol/L and (6.929-±0.604) mmol/L].The differences of the concentration of creatinine and urea between CUUO-R group and sham group were statistically significant (P ＜ 0.05).There was no significant difference between CUUO-R + EPO group and Sham group(P ＞ 0.05).The immunohistochemistry showed that the expressions of AQP2 and AQP3 in collecting duct in CUUO-R group were significantly weaker than those of in sham group,and the expression of those in CUUO-R + EPO group were slightly weaker than sham group.These results were further confirmed by Western blot,as the relative quantity of AQP2 and AQP3 were also the lowest in CUUO-R group (AQP2 in 3 groups were 0.974 ± 0.109,1.923 ± 0.097 and 2.002 ± 0.044,F =392.4,P =0.000;AQP3 in 3 groups were 0.941 ± 0.048,1.497 ± 0.043 and 1.863 ± 0.043,F =735.8,P =0.000).Conclusions EPO treatment is beneficial for the recovery expression of AQP2 and AQP3 as well as renal function at the early period after the release of ureteral obstruction in young rats.
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OBJECTIVE: To compare the safety and efficacy between a covered metallic ureteral stent (CMS) and a double-J ureteral stent (DJS) for the treatment of a malignant ureteral obstruction (MUO). MATERIALS AND METHODS: Nineteen patients (seven men and 12 women; mean age, 53.4 years) were randomly assigned to the CMS (n = 10) or DJS (n = 9) group. The following were compared between the two groups: technical success, i.e., successful stent placement into desired locations; stent malfunction; stent patency, i.e., no obstruction and no additional intervention; complications; and patient survival. RESULTS: The technical success rate was 100% in all 10 and 12 ureteral units in the CMS and DJS groups, respectively. During the mean follow-up period of 253.9 days (range, 63–655 days), stent malfunction was observed in 40.0% (4/10) and 66.7% (8/12) in the CMS and DJS groups, respectively. In the per-ureteral analysis, the median patency time was 239.0 days and 80.0 days in the CMS and DJS groups, respectively. The CMS group yielded higher patency rates compared with the DJS group at three months (90% vs. 35%) and at six months (57% vs. 21%). The overall patency rates were significantly higher in the CMS group (p = 0.041). Complications included the migration of two metallic stents in one patient in the CMS group, which were removed in a retrograde manner. The two patient groups did not differ significantly regarding their overall survival rates (p = 0.286). CONCLUSION: Covered metallic ureteral stent may be effective for MUO.
Subject(s)
Female , Humans , Male , Follow-Up Studies , Prospective Studies , Stents , Survival Rate , Ureter , Ureteral ObstructionABSTRACT
Objective To investigate the effect of erythropoietin(EPO)on the expression of aquaporin - 2 (AQP2)in the kidney of young SD rats after release of bilateral ureter obstruction(BUO - R). Methods Thirty - two young SD rats were equally divided into 4 groups randomly(BUO group,BUO - R group,BUO - R ﹢ EPO group and Sham group,8 rats in each group). The BUO model was built through bilateral ureteral ligation. EPO(500 U/ kg)was given to BUO - R ﹢ EPO rats at 2 h after release of BUO,and then repeated 6 h,12 h,24 h and 36 h thereafter and the same volume of 9 g/ L saline was simultaneously given to BUO - R rats. The Sham group was prepared in parallel by laparotomy and free dissection of bilateral ureters but not ligated. Both side kidneys were harvested 48 h(72 h for Sham group)after release of BUO to examine the effect of EPO on the expression of AQP2 in inner medulla by immunohisto-chemistry,Real - time PCR and Western blot. The urine samples were collected by using metabolic cage before death. Results The osmotic pressure of BUO - R ﹢ EPO group was higher than that of BUO - R group,but lower than that of Sham group(P ﹤ 0. 05). Immunohistochemistry showed that the collecting duct wall thinned and lumen enlarged. After the pictures were analysized by using Image - Pro Plus software,it showed that the expression of AQP2 in collecting duct in BUO group was significantly down - regulated compared with that in Sham group,whereas,it was slightly weaker in BUO - R group and BUO - R ﹢ EPO group than Sham group(P ﹤ 0. 05). These results were further confirmed by a-dopting Western blot,and the relative quantity of AQP2 in BUO group was also the lowest of the four groups(P ﹤0. 05). Real - time PCR showed that the level of AQP2 mRNA in Sham group was(24. 30 ± 1. 03)folds of BUO group,(10. 60 ± 1. 05)folds of BUO - R group and(5. 70 ± 1. 01)folds of BUO - R ﹢ EPO group,respectively. Conclusion EPO could promote not only the recovery of AQP2 mRNA and protein expression but also the recovery of AQP2 function in young BUO - R rats.
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Objective To investigate the expression of monocyte-macrophage-related factors and interstitial fibrosis in kidney tissues of rats with ureter obstruction and recanalization .Methods Forty-eight male Spragur-Dawley rats were divided randomly into the obstructive group:sham (n=6), unilateral ureteral obstruction(UUO)3 days (n=6), UUO 7 days (n=6), and UUO 14 days (n=6) and recanalization group:bilateral ureteral obstruction(RBUO)0 day (n=6), 3 days after RBUO (n=6), 7 days after RBUO (n=6), and 14 days after RBUO (n=6).The kidneys were excised on day 3, 7, and 14, and the deposition of collagen fibers in kidney was detected with HE and Masson staining . Immunohistochemical analysis was performed to evaluate the protein expressions of monocyte chemoattractant protein -1 (MCP-1), macrophage colony-stimulating factor (M-CSF) and activated-macrophage marker CD68.Real-time PCR was used to detect the mRNA expressions of MCP-1 and M-CSF.TGF-β1 levels were determined by ELISA .Results Fibrosis observed with HE and Masson staining was obviously increased in kidney tissue of UUO rats , and aggravated as time prolonged, but alleviated in rats with recanalization .TGF-β1 levels were increased obviously in the UUO group , but decreased in rats with recanalization compared with those in BUO rats .In UUO rats, mRNA and protein expression levels of MCP-1 and M-CSF were increased .MCP-1 and M-CSF expression was gradually decreased in rats with recanalization compared with those in BUO rats .The dynamic change in expression of MCP-1 and M-CSF in both UUO rats and recanalization rats was consistent with the change in expression of CD 68. Conclusion Dynamic change in expression of MCP-1 and M-CSF in kidney tissues reflects change of activated and accumulated monocyte -macrophages , which may be one of the major mechanisms contributing to fibrosis induced by ureter obstruction .Renal fibrosis is alleviated by down-regulated expression of monocyte-macrophages factors with recanalization operation .
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Pelvic actinomycosis is a rare infectious disease in female genital organ, which occurs most commonly with intrauterine device. Because of it's diverse clinical manifestation and progress, the diagnosis is made postoperatively by pathologic confirm in most cases and adequate medical treatment is required. Ureter obstruction is one of the common complication of pelvic actinomycosis, but it's management has been very variable by cases. If physician operate this after adequate management of ureter and preoperative antibiotics therapy, the risk of pelvic structure injury is reduced and then a patient can be saved from an extensive surgical procedure. We experienced a case of pelvic actinomycosis complicated by tubo-ovarian abscess with ureter obstruction and hydronephrosis, improving by Double J catheter insertion and preoperative antibiotics therapy and report it with brief review of literatures.
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Female , Humans , Abscess , Actinomycosis , Anti-Bacterial Agents , Catheters , Communicable Diseases , Diagnosis , Genitalia , Hydronephrosis , Intrauterine Devices , UreterABSTRACT
Objective: To investigate the development of tubulointerstitial fibrosis caused by partial unilateral ureter obstruction(PUUO) and the improvement of tubulointerstitial fibrosis after obstruction was relieved. Methods: PUUO was induced by the method of embedding upper half of the ureter into ipsilateral psoas.Obstruction was relieved by dissecting the ureter from psoas groove and returning its normal anatomical position.Pathology examination were performed,and collagenⅠand Ⅲ were semi-quantified by immunohistochemistry assay. Results: Massive accumulation of TypeⅠand Ⅲ collagen in tubulointerstitium leads to renal fibrosis.Renal fibrosis can recover if obstruction be relieved within 4 weeks. Conclusion: The results indicated tubuloinsterstitisl fibrosis develop progressively after PUUO,and fibrosis reduce by obstruction relief.
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Objective To investigate the effect of fosinopril on the expression of transforming growth factor (TGF)-activated kinase 1 (TAK-1) in the kidney of rats with unilateral ureteral obstruction (UUO),and its protective effect on renal interstitial fibrosis (RIF).Methods UUO model was induced by ligating the left ureter in rats.A total of 72 male Sprague-Wistar rats were randomly divided into 3 groups:sham-operated group (n=24),UUO model group (n=24) and UUO+fosinopril group (n=24).The rats were treated with 10 mg/(kg?d) by gastric gavage in the fosinopril treated group from 2 d after the operation,and the rats were treated with the identical dose of normal saline in the other 2 groups.Eight rats of each group were sacrificed at 7,14 and 21 d after UUO.Pathological changes of the renal tissue were observed by HE and Masson staining,and the mRNA and protein expression of TAK1 was detected by in situ hybridization,real-time PCR and Western blot analysis.Results The renal interstitial damage index of UUO group was increased compared with that of the sham-operation group (P
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Objective To investigate the mechanism of renal interstitial fibrosis after unilateral ureteral obstruction and renal protctive effect of angiotensin coverting enzyme inhibitor (ACEI),benazepril on rat kidney.Methods Twenty-four rats were randomly assigned to shame operation group (normal group),operation group, benazepril(10mg?kg -1 ?d -1 ) treatment group after unilateral ureteral obstruction. Renal tissues were examined by light and electronmicroscopy at the 2nd week after operation. Immunohistochemistry was applied to measure the expression of collagen Ⅲ,transforming growth factor ? 1 (TGF-? 1 ) and nuclear factor-kB(NF-kB) in the renal interstitium.Results In comparison with shame operation group, the expression of collagen Ⅲ , TGF-? 1 and NF-kB in the interstitium of operation group markedly increased (P
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PURPOSE: To determine the usefulness of MR urography technique for the evaluation of urinary systems in patients with obstructed urinary tract and normal volunteers with non-obstructed urinary tract after intravenous normal saline and diuretic injection. MATERIALS AND METHODS: Three normal volunteers and 12 patients with urinary tract obstruction [ureteral calculi(n=8), extraurinary mass(n=1), ureteral tumor invasion(n=3)] underwent MR urography using a 1.0T scanner and a 2D non-breath-hold heavily T2-weighted fast spin-echo sequence. These acquisition were postprocessed with a maximum intensity projection (MIP) algorithm. Two acquisitions were performed, the first prior to saline solution infusion following standard MR urography procedures, and the second, within 2-3 minutes of the infusion of 250 ml saline solution followed by 20 mg of Lasix administered intravenously. For this latter, drug-induced MR urography procedures were followed. RESULTS: In healthy volunteers (n=3) and those experiencing partial obstruction (n=4) by a urinary stone, drug-induced MR urography provided better images of the urinary tract than did standard MR urography. In those in whom a urinary stone or tumor had caused complete obstruction (n=8), standard MR urography provided good images, as did drug-induced MR urography. CONCLUSION: In patients with a partially or non-obstructed urinary tract, drug-induced MR urography provided better anatomic and functional details of the kidney and urinary tract than did standard MR urography. In those experiencing complete obstruction of the urinary tract, however, standard or drug-induced MR urography permitted very adequate evaluation of the tract, and drug-induced MR urography was unnecessary.
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Humans , Furosemide , Healthy Volunteers , Hydronephrosis , Kidney , Sodium Chloride , Ureter , Urinary Calculi , Urinary Tract , UrographyABSTRACT
Objective To evaluate the diagnostic value of MSCT longitudinal reconstruction in the ureteral obstruction.Methods 34 patients with ureteral obstruction were scaned transversely and longitudinally by GE Lightspeed 16 CT scanner and the images were reconstructed with three-dimensional software.All cases were proved by operation and pathology except for 2 cases of uretal obstruction compressed by retroperitoneal lymph nodes.Results In 34 cases,there were 22 cases of ureteral calculi,2 cases of ureteritis,3 cases of carcinoma of ureter,3 cases of pelvisureteral conjunction stricture,1 case of ureteral cyst,1 case of retrocaval ureter and 2 cases of ureter compressed by retroperitoneal metastatic lymph nodes.On longitudinal reconstruction images,22 lesions of calculi in the ureter and thickened uretal wall were showed.Contrast-enhanced CT scan was preformed in 5 cases,the CT values of lesions were increased about 20~35 HU,after administration of contrast medium,and light hydronephrosis in 18 cases,medium hydronephrosis in 6,serious hydronephrosis in 2 and no hydronephrosis in one case were showed on delayed contrast-enhanced scan.Conclusion Longitudinal reconstruction image is of significant value in diagnosis of ureteral obstruction.
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Wegener`s granulomatosis (WG) is a multisystem disorder of unknown origin characterized by necrotizing granulomatous vasculitis. WG usually affects the upper respiratory tract, lungs, and kidneys with focal glomerulonephritis, but almost any organ can be affected. The ureter is primarily an unusual location for lesions of WG. A 30-year-old woman presented with intermittent right flank pain and hematuria. A renal ultrasound demonstrated unilateral hydronephrosis and a retrograde pyelography revealed a filling defect at right mid ureter and a computed tomography displayed marked concentric thickening of the right ureteral wall which was mimicking ureteral tumor. At nephroureterectomy, the right ureter was found to be obstructed by dense, intramural fibroinflammatory reaction. There was a necrotizing granulomatous vasculitis in the muscle layer of the ureter. Our case represents the rare occurrence of WG presenting ureteral bstruction.
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Adult , Female , Humans , Flank Pain , Glomerulonephritis , Hematuria , Hydronephrosis , Kidney , Lung , Respiratory System , Ultrasonography , Ureter , Urography , VasculitisABSTRACT
In Wegener's granulomatosis, the classical clinical picture is composed of a triad of symptoms: sinusitis-rhinitis, pulmonary lesion and glomerulonephritis with granulomatous lesions and necrotizing vasculitis of involved organs. But localization in retroperitoneal tissue is unusual. In this case, hydronephrosis and ureteral obstruction is the sole presenting symptoms of the disease. At exploratory laparotomy, the right ureter was found to be obstructed by dense, extrinsic fibroinflammatory reaction. There was a necrotizing granulomatous vasculitis in the muscle layer of the ureter.
Subject(s)
Glomerulonephritis , Hydronephrosis , Laparotomy , Ureter , Ureteral Obstruction , Vasculitis , Granulomatosis with PolyangiitisABSTRACT
Palliative endourologic treatment was done in 94 cases for ureteral obstruction secondary to advanced malignancy The average survival was 4.2 months. The obstruction were caused by metastases or invasion of cancer in all patients. First we tried to insert a double J stent(STENT), when it failed percutaneous nephrostomy(PCN) was performed. Initially 16 patients were treated by STENT and 8 patients by PCN. The SIENT was changed 2.2 times on the average in all patients. 75% of the patients who had been treated by STENT experienced only one or two times of STENT changes before dying. Patency period of the STENT was 57.6 days on the average. The patency period was shorter in the patients who showed gross hematuria at the time of STENT insertion. Although survival was not so long, 60.6% patients were able to return to their homes. The endourologic management of the upper urinary tract obstruction will play a more important role and offer a better quality of life for end stage cancer patients.