Abbreviations: ON, open nephrostomy. PCN, percutaneous nephrostomy, Scr, serum creatinine, GI, gastrointestinal, Gynae, gynaecological, Uro, urological, NA, not available, hydrop, hydronephrosis
| Study (Study period) | N patients/ureters | Primary malignancy | Type of stent | Successful stent insertion | Failure of stent function | Average survival time (range) | Renal function | Complications | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Ku 2004 (2000-2002) | 68 stent | NA | 7F/8F Percuflex | 87.2% | 11% | NA | Decrease in Scr 1.4 ± 0.4 g/L | Stent/catheter 8/68 (12%) | Febrile episodes 10% | Acute pylonephritis 5.9% | ||
| 80 PCN | NA | 1.3% | 2.5 ± 0.2 g/L p=0.058 | 7/80 (9%) | 15% | 3.8% | ||||||
| Kanou 2007 (1990-2003) | 51 stent | Cervix 31% Rectal 23% Prostate 15% | 6F C-Flex, Percuflex | 72.5% | 21.6% | 5.6 mo | Scr (mg/dL) Pre-op = 4.9 Post-op = 1.1 100% recovered renal insufficiency | Early catheter replacement 5/29 (17%) | Lower abdominal discomfort 2/29 (7%) | |||
| 24 PCN | 14-Fr Malecot or balloon | NA | NA | 5.9 mo | Accidental catheter withdrawal 9/46 (20%) | Pain + dermatitis 3/46 (7%) Minor haemorrhaging 2/46 (4%) | ||||||
| Chitale 2002 (1998-2000) | 65 24 stent | Prostate 43% Bladder 46% | NA | 21%14 | NA | NA | NA | 1 patient had cystectomy and urinary diversion for MIBC | ||||
| 60 PCN | 95% | 1.7% | ||||||||||
| Wong 2007 (1991-2003) | 102 25 stent | Gynae 31% Uro 29% GI 21% | NA | 16%15 | 6.8 mo 9.2 mo | NA | Overall 14/25 (56%) | Infection 5/25 (20%) | Blockage 8/25 (32%) | Haemorrhage 2/25 (8%) | ||
| 77 PCN | 1% | 6.5 mo | 40/76 (53%) | 27/77 (35%) | 19/77 (25%) | 2/77 (3%) | ||||||
| Chang 2012 (2003-2009) | 66 stent | 56/110 (51%) benign, 54/110 (49%) malignant mostly cervical16 | 7-Fr Inlay | 9/86 (10%) converted to PCN due to failure | Residual hydrop 43/66 (65%) | Change in Scr 0.78 (-1.8 – 1.2) mg/dL | Stent group had more frequent UTI, including urosepsis and pyelonphritis, than the PCN group, although this difference was non-significant (numbers not reported). | |||||
| 44 PCN | 12/44 (27%) p=0.01 | 0.21 (-2.4 – 1.9) mg/dL p=0.003 | ||||||||||
| Hübner 1993 (1986-1989) | 24 stent | Colon 29% Bladder 25% Cervical 17% | NA | NA | NA | 6.1 mo (all patients) | NA | Flank pain 8/34 (24%) | Dysuria 7/34 (21%) | Stent dislocation 1/34 (3%) | ||
| 28 PCN | Accidental tube dislodgement 5/16 (31%) | |||||||||||
Low success of retrograde stenting due to inability to cannulate the ureteric orifices due to trigonal distortion or failure to negotiate the lower segment ureter in 17/19 (89%) patients
All failures with primary retrograde stents occurred in prostate or bladder cancer
Malignant and benign obstructions not reported separately
From: 5, Managing locally advanced or metastatic bladder cancer
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