Ureteral stenting in patients with locally advanced cervical cancer: Predictors of low success rate
- PMID: 39286433
- PMCID: PMC11402550
- DOI: 10.1016/j.gore.2024.101491
Ureteral stenting in patients with locally advanced cervical cancer: Predictors of low success rate
Abstract
Objective: Cervical cancer is the leading gynecologic malignancy in Ethiopia. The diagnosis is often delayed and many patients present with locally advanced disease. Involvement of the ureters with or without the development of hydroureteronephrosis is a common finding. Ureteral stent placement is a modality utilized to relieve an established obstruction (therapeutic) or to prevent its early occurrence (prophylactic). However, the procedure may not be successful in all patients. The objective of this study is to assess the factors associated with low success rate of ureteral stenting in these patients with locally advanced disease.
Methods: This is a hospital based cross-sectional study of patients diagnosed with locally advanced cervical cancer for whom a retrograde ureteral stent placement is attempted from January 2019 to March 2020. Data of 175 patients were retrieved by a retrospective chart review and analyzed for factors associated with low procedural success.
Results: Socio-demographic data were similar between patients regardless of procedural success. The overall success rate of stenting was 54.2 %. In the prophylactic group (with no hydronephrosis and normal creatinine) success rate was 94 % and in the therapeutic group 42.6 %. Logistic regression analysis showed that bilateral hydronephrosis and increased serum creatinine were indicators of significant ureteral obstruction and were predictors of stent placement failure.
Conclusion: Increased serum creatinine and presence of hydronephrosis are risk factors for failed ureteral stenting. For these patients, other options of urinary diversion such as percutaneous nephrostomy should be considered from the outset.
Keywords: Cervical cancer; Hydronephrosis; Locally advanced; Serum creatinine; Ureteral obstruction; Ureteral stenting.
© 2024 The Author(s).
Conflict of interest statement
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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References
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- Derek L., Matthew Z. American Urological Association (AUA) News; 2023. Update on the Management of Malignant Ureteral Obstruction.
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- Disease prevention and control directorate. Federal Ministry of Health of Ethiopia, National cancer control plan 2016–2020, October 2015.
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