Percutaneous Nephrostomy Versus Retrograde Ureteral Stent for Management of Malignant Ureteral Obstruction in Adults: a Systematic Review of the Literature
BackgroundMalignant ureteral obstruction (MUO) is a common presentation in advanced urological and non-urological malignancies. Percutaneous nephrostomy (PCN) and retrograde ureteral stent (RUS) are the most commonly performed procedures to relieve the obstruction. The comparative effect...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Société Internationale d’Urologie (SIU)
2023-09-01
|
| Series: | Société Internationale d’Urologie Journal |
| Subjects: | |
| Online Access: | https://siuj.org/index.php/siuj/article/view/301/253 |
| _version_ | 1827267799738744832 |
|---|---|
| author | Walid Eshumani Mathieu Roumiguié Peter C. Black |
| author_facet | Walid Eshumani Mathieu Roumiguié Peter C. Black |
| author_sort | Walid Eshumani |
| collection | DOAJ |
| description | BackgroundMalignant ureteral obstruction (MUO) is a common presentation in advanced urological and non-urological malignancies. Percutaneous nephrostomy (PCN) and retrograde ureteral stent (RUS) are the most commonly performed procedures to relieve the obstruction. The comparative effectiveness of PCN and RUS for decompression of MUO remains uncertain.
PurposeTo systematically review the literature for evidence of improved efficacy of one of these procedures in terms of renal function preservation and clinical outcomes.
MethodsWe searched Ovid Medline, Ovid EMBASE, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus from the date of inception to October 2022. In addition, gray literature was searched through OpenGray (https://opengrey.eu/), dissertation and thesis database (ProQuest) via (https://www.proquest.com), and Clinical trial.gov website. The reference lists of all the included studies were also searched.Two reviewers independently reviewed and selected studies, assessed the quality, and extracted the data.
ResultsOverall, 25 eligible studies including 1864 patients compared PCN and RUS (head-to-head). PCN and RUS were found to be similarly effective in improving renal function. However, PCN appears to be superior in maintaining this reduction. The complication rate and quality of life were comparable between the 2 methods, but the length of hospital stay and the financial cost were significantly higher in the PCN group. The mean technical success rate in RUS was 70.3% (21% to 100%) and in PCN was 98.8% (90% to 100%). The conversion rate from RUS to PCN ranged from 10% to 42.6% (mean = 22.5%), while internalization of the PCN occurred in 11.7% to 98% of the patients (mean = 45.5%).
ConclusionsBoth diversional methods are effective in management of MUO. However, because of the heterogeneity of the included studies, the superiority of one of the procedures cannot be concluded. |
| first_indexed | 2024-03-08T18:31:42Z |
| format | Article |
| id | doaj.art-63ce3e4bd2534a0dbb1576e4c94186e5 |
| institution | Directory Open Access Journal |
| issn | 2563-6499 |
| language | English |
| last_indexed | 2025-03-22T04:39:29Z |
| publishDate | 2023-09-01 |
| publisher | The Société Internationale d’Urologie (SIU) |
| record_format | Article |
| series | Société Internationale d’Urologie Journal |
| spelling | doaj.art-63ce3e4bd2534a0dbb1576e4c94186e52024-04-27T23:31:21ZengThe Société Internationale d’Urologie (SIU)Société Internationale d’Urologie Journal2563-64992023-09-014540141410.48083/AYKF2124Percutaneous Nephrostomy Versus Retrograde Ureteral Stent for Management of Malignant Ureteral Obstruction in Adults: a Systematic Review of the LiteratureWalid EshumaniMathieu RoumiguiéPeter C. BlackBackgroundMalignant ureteral obstruction (MUO) is a common presentation in advanced urological and non-urological malignancies. Percutaneous nephrostomy (PCN) and retrograde ureteral stent (RUS) are the most commonly performed procedures to relieve the obstruction. The comparative effectiveness of PCN and RUS for decompression of MUO remains uncertain. PurposeTo systematically review the literature for evidence of improved efficacy of one of these procedures in terms of renal function preservation and clinical outcomes. MethodsWe searched Ovid Medline, Ovid EMBASE, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus from the date of inception to October 2022. In addition, gray literature was searched through OpenGray (https://opengrey.eu/), dissertation and thesis database (ProQuest) via (https://www.proquest.com), and Clinical trial.gov website. The reference lists of all the included studies were also searched.Two reviewers independently reviewed and selected studies, assessed the quality, and extracted the data. ResultsOverall, 25 eligible studies including 1864 patients compared PCN and RUS (head-to-head). PCN and RUS were found to be similarly effective in improving renal function. However, PCN appears to be superior in maintaining this reduction. The complication rate and quality of life were comparable between the 2 methods, but the length of hospital stay and the financial cost were significantly higher in the PCN group. The mean technical success rate in RUS was 70.3% (21% to 100%) and in PCN was 98.8% (90% to 100%). The conversion rate from RUS to PCN ranged from 10% to 42.6% (mean = 22.5%), while internalization of the PCN occurred in 11.7% to 98% of the patients (mean = 45.5%). ConclusionsBoth diversional methods are effective in management of MUO. However, because of the heterogeneity of the included studies, the superiority of one of the procedures cannot be concluded.https://siuj.org/index.php/siuj/article/view/301/253malignant ureteral obstructionhydronephrosispercutaneous nephrostomyretrograde ureteral sten |
| spellingShingle | Walid Eshumani Mathieu Roumiguié Peter C. Black Percutaneous Nephrostomy Versus Retrograde Ureteral Stent for Management of Malignant Ureteral Obstruction in Adults: a Systematic Review of the Literature Société Internationale d’Urologie Journal malignant ureteral obstruction hydronephrosis percutaneous nephrostomy retrograde ureteral sten |
| title | Percutaneous Nephrostomy Versus Retrograde Ureteral Stent for Management of Malignant Ureteral Obstruction in Adults: a Systematic Review of the Literature |
| title_full | Percutaneous Nephrostomy Versus Retrograde Ureteral Stent for Management of Malignant Ureteral Obstruction in Adults: a Systematic Review of the Literature |
| title_fullStr | Percutaneous Nephrostomy Versus Retrograde Ureteral Stent for Management of Malignant Ureteral Obstruction in Adults: a Systematic Review of the Literature |
| title_full_unstemmed | Percutaneous Nephrostomy Versus Retrograde Ureteral Stent for Management of Malignant Ureteral Obstruction in Adults: a Systematic Review of the Literature |
| title_short | Percutaneous Nephrostomy Versus Retrograde Ureteral Stent for Management of Malignant Ureteral Obstruction in Adults: a Systematic Review of the Literature |
| title_sort | percutaneous nephrostomy versus retrograde ureteral stent for management of malignant ureteral obstruction in adults a systematic review of the literature |
| topic | malignant ureteral obstruction hydronephrosis percutaneous nephrostomy retrograde ureteral sten |
| url | https://siuj.org/index.php/siuj/article/view/301/253 |
| work_keys_str_mv | AT walideshumani percutaneousnephrostomyversusretrogradeureteralstentformanagementofmalignantureteralobstructioninadultsasystematicreviewoftheliterature AT mathieuroumiguie percutaneousnephrostomyversusretrogradeureteralstentformanagementofmalignantureteralobstructioninadultsasystematicreviewoftheliterature AT petercblack percutaneousnephrostomyversusretrogradeureteralstentformanagementofmalignantureteralobstructioninadultsasystematicreviewoftheliterature |