Factores asociados al fracaso en la colocación de catéteres doble J en pacientes con uropatía obstructiva por cáncer

Aim

To analyze the clinical, imaging, and surgical factors that are associated with failed double-J stent placement in patients with obstructive uropathy due to cancer.

Materials and methods

An analytic, cross-sectional study was conducted. The variables analyzed were: age, sex, oncologic diagnosis, clinical stage, diagnostic time course, treatment received, preoperative laboratory studies (Hb, leuc, Cr, BUN, urea), imaging studies (US or CAT), and the surgical attempt to place the double-J stent. A comparative analysis was done between the failed and successful placement groups. Statistical analysis was carried out using the Mann-Whitney U test and the chi-square test, and finally, the odds ratio with a 95% confidence interval was employed.

Results

Of the 48 patients, 27 had failed double-J stent placement and 21 had successful placement. Risk factors for failed placement were elevated preoperative levels of urea ≥ 40 mg/dL (OR: 16.67, CI: 2.66-134.92 [P = .0001]), creatinine ≥ 2 mg/dL (OR:7.27, CI:1.41-42.25 [P = .004]), and BUN ≥ 40 mg/dL (OR:4.00, CI: 0.93-18.06 [P = .031]) and a low Hb level ≤ 9 mg/dL (OR:6.32, CI:1.37-21.55 [P = .005]), as well as a deformed trigone (OR:3.29, IC:1.18-9.19 [P = .002]).

Conclusions

Elevated preoperative levels of creatinine, urea, and BUN, and a deformed bladder trigone are markers for failed double-J stent placement.