Subcutaneous nephrovesical bypass: Treatment for ureteral obstruction in advanced metastatic disease

Wang,Yunyan; Wang,Gongcheng; Hou,Peijin; Zhuang,Haijun; Yang,Xiaosong; Gu,Shuo; Wang,Hengbing; Ji,Lu; Xu,Zongyuan; Meng,Junsong

doi:10.3892/ol.2014.2679

Subcutaneous nephrovesical bypass: Treatment for ureteral obstruction in advanced metastatic disease

Authors:
- Yunyan Wang
- Gongcheng Wang
- Peijin Hou
- Haijun Zhuang
- Xiaosong Yang
- Shuo Gu
- Hengbing Wang
- Lu Ji
- Zongyuan Xu
- Junsong Meng
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Affiliations: Department of Urology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu 223300, P.R. China
Published online on: November 6, 2014 https://doi.org/10.3892/ol.2014.2679
Pages: 387-390

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Abstract

The aim of the present study was to explore the value of subcutaneous nephrovesical bypass (SNVB) for the treatment of ureteral obstruction due to pelvic metastatic disease. SNVB stents (n=30) were implanted in 24 patients with advanced metastatic disease between January 2008 and December 2012. Urinalysis, serum creatinine (SCr), glomerular filtration rate (GFR), quality of life (QoL) scores, and renal ultrasonography were evaluated at follow‑up. The SNVB procedures were successful in all 24 patients. Patient follow‑ups occurred at an average of 10.6 months. Preoperative hydronephrosis was eliminated in 16 cases (53.3%) and reduced in the remaining patients. Following surgery, SCr levels reduced significantly from 256±46 to 124±23 µmol/l (P<0.001). GFRs increased from 25±4.8 to 45±5.3 ml/min (P<0.01). The mean QoL scores were 3.4±1.4 preoperatively and 7.6±1.0 postoperatively (P<0.001). The results showed that SNVB is a minimally invasive, effective and safe procedure for patients with ureteral obstruction resulting from advanced malignant disease. As an alternative procedure to percutaneous nephrostomy, SNVB offers patients a better QoL.

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1	Kouba E, Wallen EM and Pruthi RS: Management of ureteral obstruction due to advanced malignancy: optimizing therapeutic and palliative outcomes. J Urol. 180:444–450. 2008. View Article : Google Scholar : PubMed/NCBI
2	Chung SY, Stein RJ, Landsittel D, et al: 15-year experience with the management of extrinsic ureteral obstruction with indwelling ureteral stents. J Urol. 172:592–595. 2004. View Article : Google Scholar : PubMed/NCBI
3	Ekici S, Şahin A and Özen H: Percutaneous nephrostomy in the management of malignant ureteral obstruction secondary to bladder cancer. J Endourol. 15:827–829. 2001. View Article : Google Scholar : PubMed/NCBI
4	Watkinson AF, A’Hern RP, Jones A, King DM and Moskovic EC: The role of percutaneous nephrostomy in malignant urinary tract obstruction. Clin Radiol. 47:32–35. 1993. View Article : Google Scholar : PubMed/NCBI
5	Radecka E and Magnusson A: Complications associated with percutaneous nephrostomies. A retrospective study. Acta Radiol. 45:184–188. 2004. View Article : Google Scholar : PubMed/NCBI
6	Chitale SV, Scott-Barrett S, Ho ET and Burgess NA: The management of ureteric obstruction secondary to malignant pelvic disease. Clin Radiol. 57:1118–1121. 2002. View Article : Google Scholar : PubMed/NCBI
7	Ganatra AM and Loughling K: The management of malignant ureteral obstruction treated with ureteral stents. J Urol. 174:2125–2128. 2005. View Article : Google Scholar : PubMed/NCBI
8	Rosenberg BH, Bianco FJ Jr, Wood DP Jr and Triest JA: Stent-change therapy in advanced malignancies with ureteral obstruction. J Endourol. 19:63–67. 2005. View Article : Google Scholar : PubMed/NCBI
9	Wah TM, Weston MJ and Irving HC: Percutaneous nephrostomy insertion: outcome data from a prospective multi-operator study at a UK training centre. Clin Radiol. 59:255–261. 2004. View Article : Google Scholar : PubMed/NCBI
10	Wong LM, Cleeve LK, Milner AD and Pitman AG: Malignant ureteral obstruction: outcomes after intervention. Have things changed? J Urol. 178:178–183. 2007. View Article : Google Scholar : PubMed/NCBI
11	Emmert C, Rassler J and Kohler U: Survival and quality of life after percutaneous nephrostomy for malignant ureteric obstruction in patients with terminal cervical cancer. Arch Gynecol Obstet. 259:147–151. 1997. View Article : Google Scholar : PubMed/NCBI
12	Aravantinos E, Anagnostou T, Karatzas AD, Papakonstantinou W, Samarinas M and Melekos MD: Percutaneous nephrostomy in patients with tumors of advanced stage: treatment dilemmas and impact on clinical course and quality of life. J Endourol. 21:1297–1302. 2007. View Article : Google Scholar : PubMed/NCBI
13	Jurczok A, Loertzer H, Wangner S and Fornara P: Subcutaneous nephrovesical and nephrocutaneous bypass. Gynecol Obstet Invest. 59:144–148. 2005. View Article : Google Scholar : PubMed/NCBI
14	Desgrandchamps F, Leroux S, Ravery V, Bochereau G, Menut P and Meria P: Subcutaneous pyelovesical bypass as replacement for standard percutaneous nephrostomy for palliative urinary diversion: prospective evaluation of patient’s quality of life. J Endourol. 21:173–176. 2007. View Article : Google Scholar : PubMed/NCBI
15	Li J and Wang XF: Clinical application of subcutaneous nephrovesical bypass system. Beijing Da Xue Bao. 42:473–475. 2010.(In Chinese).
16	Schmidbauer J, Kratzik C, Klingler HC, Remzi M, Lackner J and Marberger M: Nephrovesical subcutaneous ureteric bypass: long-term results in patients with advanced metastatic disease-improvement of renal function and quality of life. Eur Urol. 50:1073–1078. 2006. View Article : Google Scholar : PubMed/NCBI
17	Nissenkorn I and Gdor Y: Nephrovesical subcutaneous stent: an alternative to permanent nephrostomy. J Urol. 163:528–530. 2000. View Article : Google Scholar : PubMed/NCBI
18	Gerullis H, Ecke TH, Schwartmann K, Heuck CJ, Eimer C, Bagner JW, et al: Nephrocutaneous bypass in ureteral obstruction. Urology. 76:480–485. 2010. View Article : Google Scholar : PubMed/NCBI
19	Jabbour ME, Desgrandchamps F, Angelescu E, Teillac P and Le Duc A: Percutaneous implantation of subcutaneous prosthetic ureters: long-term outcome. J Endourol. 15:611–614. 2001. View Article : Google Scholar : PubMed/NCBI
20	Cockburn JF and Nisbet P: Percutaneous radiologic replacement of blocked nephrovesical stent. AJR Am J Roentgenol. 170:1109–1110. 1998. View Article : Google Scholar : PubMed/NCBI