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Organo Oficial de la Sociedad Mexicana de Urología

2023, Number 2

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Rev Mex Urol 2023; 83 (2)

Ureteral stent insertion failure in obstructive uropathy secondary to cervical cancer

Cervantes-Miranda DE, Pallares-Méndez R, Villarreal-del-Bosque IS, Negreros-Osuna AA, Hernández-Aranda KL, De la Cruz-de la Cruz C, Gutiérrez-González A, Arrambide-Gutiérrez G

Language: English
References: 18
Page: 1-10
PDF size: 261.89 Kb.


ABSTRACT

Introduction: To identify preoperative features that predict ureteral stent placement failure in women with obstructive uropathy secondary to cervical cancer.
Methods: Observational, descriptive, analytical study. Clinical registries of patients with diagnosis of obstructive uropathy secondary to cervical cancer were reviewed. Fifty-two patients attended between January 2017 to January 2021 were included. Diagnosis of obstructive uropathy consisted of hydronephrosis or hydroureter in imaging studies and elevation in baseline serum creatinine and blood urea nitrogen with uremic syndrome. An analysis of variables of interest was carried out to assess the association with ureteral stent placement failure.
Results: We observed that the overall rate of failed ureteral stent placement was 55.8%. We did not find any differences in baseline characteristics between patients with successful or unsuccessful ureteral stent placement. A higher percentage of patients with failed urinary diversion on admission had a decrease in urinary output (58.6% vs. 30.4%, p=0.04), uremic syndrome (51.7% vs. 21.7%, p=0.02), as well as an increased median serum creatinine (6.6 vs. 2.6 mg/dL, p=0.03) compared to patients with successful ureteral stent placement. An admission serum creatinine cut-off value of 3.4 mg/dL yielded sensitivity of 69% and specificity of 65.2% for unsuccessful ureteral stent placement (AUC=0.674, 95% CI 0-52-0.82; p=0.03).
Conclusion: Our data suggest that distal ureteral obstruction evidenced by imaging, regardless of the extent of invasion, is the most important factor related to unsuccessful ureteral stent placement.


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