Likelihood of retrograde double-J stenting according to ureteral obstructing pathology
Int. braz. j. urol
; 31(5): 431-436, Sept.-Oct. 2005. tab
Article
in English
| LILACS
| ID: lil-418161
Responsible library:
BR1.1
RESUMO
OBJECTIVES:
To evaluate the likelihood of retrograde double-J stenting in urgent ureteral drainage according to obstructing pathology. MATERIALS ANDMETHODS:
From July 2002 to January 2003, 43 consecutive patients with ureteral obstruction who needed urgent decompression were evaluated at our institution, where we performed a total of 47 procedures. Emergency was defined as ureteral obstruction associated with infection, obstructive acute renal failure, or refractory pain. Ureteral obstruction was defined as intrinsic and extrinsic based on etiology and evaluated by ultrasound. Patients submitted to previous double-J stenting were excluded. Failures in retrograde ureteral stenting were treated with percutaneous nephrostomy. Results were analyzed with Fisher's exact test and regression analysis.RESULTS:
Failure in retrograde ureteral stenting occurred in 9 percent (2/22) and 52 percent (13/25) of the attempts in patients with intrinsic and extrinsic obstruction respectively (p < 0.001). Failures in stenting extrinsic obstructions occurred due to lack of identification of the ureteral meatus in 77 percent and impossibility of catheter progression in 23 percent (p < 0.05). All attempts of retrograde catheter insertion failed in obstructions caused by prostate or bladder pathologies (6/6). Inability to identify the ureteral meatus was the cause of all failures.CONCLUSION:
Retrograde double-J stenting has a low probability of success in extrinsic ureteral obstruction caused by prostate or bladder disease. Such cases might be best managed with percutaneous nephrostomy.
Full text:
Available
Collection:
International databases
Database:
LILACS
Main subject:
Ureteral Obstruction
/
Nephrostomy, Percutaneous
/
Stents
/
Drainage
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Decompression, Surgical
Type of study:
Diagnostic study
/
Etiology study
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Evaluation study
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Observational study
/
Risk factors
Limits:
Adult
/
Aged
/
Child
/
Female
/
Humans
/
Male
Language:
English
Journal:
Int. braz. j. urol
Journal subject:
Urology
Year:
2005
Document type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
University of Sao Paulo/BR