Clinical application of different pyelic drainage methods in the management of malignant ureteral obstruction

Abstract

Objective To assess the clinical efficacy of urinary internal ureteral stenting(IUS) and percutaneous nephrostomy(PCN) in the management of malignant ureteral obstruction complicated by renal insufficiency,to analyze its impact on the patient's quality of life,and to discuss the indications of IUS and PCN.Methods A total of 75 patients with malignant ureteral obstruction accompanied with renal insufficiency were enrolled in this study.The clinical data were retrospectively analyzed.Retrograde IUS,or anterograde IUS or PCN was carried out in each patient.The pelvis separation,creatinine and urea nitrogen levels were determined before and after the treatment.Observation of the postoperative changes in patient's quality of life was conducted.Reasonable selection of the indications was analyzed.Results After the treatment the pelvis separation,creatinine and urea nitrogen decreases from preoperative(2.76±1.25)cm,(377±236)umol/L and(19.1±8.4)mmol/L respectively to postoperative(1.32±0.60)cm(P0.01),(149±106)umol/L(P0.01) and(12.9±6.6) mmol/L(P0.01) respectively.The score of life quality decreases form preoperative 86.2±9.8 to posto-perative 84.4±9.2(P0.01).Conclusion IUS and PCN can improve the severity of hydronephrosis and renal insufficiency as well as the worsen living quality caused by malignant ureteral obstruction.The pyelic drainage pattern should be selected according to the clinical condition and the patient's own will.