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Indian Journal of Obstetrics and Gynecology

Volume  8, Issue 2, April – June 2020, Pages 52-56
 

Original Article

A Study on Role of Percutaneous Nephrostomy in Advanced Cervical Carcinoma with Obstructive Uropathy

Naveen H.N, Nataraj KM, Shaik Hussain Saheb

1Assistant Professor, Department of Urology, 2Professor of surgery, 3Assistant Professor, Department of Anatomy, S.S. Institute of Medical Sciences & Research centre, Davanagere, Karnataka 577004, India.

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DOI: http://dx.doi.org/10.21088/ijog.2321.1636.8220.9

Abstract

Background: Obstructive uropathy is a recognized complication in advanced cervical cancer. Urinary diversion is commonly used to bypass the obstruction and improve renal function. The degree of survival benefit that diversion offers is not well established and its impact on Quality of life (QoL) is uncertain. This study considered these factors in order to inform treatment decisions. Over 70% of the carcinoma cervix cases present in advanced stages of the disease and are associated with poor prognosis and high mortality rates. we evaluated our experiences with PCN in the management of cervical cancer patients presenting with obstructive uropathy with a detailed analysis of outcome, morbidity, mortality and survival rates and quality of life. Materials and Methods: A prospective study was performed with 52 patients with carcinoma cervix stage 111 and IV who underwent percutaneous nephrostomy during a 12 month period. The median age was 45 years. Follow up period was ranging from 3 months to 20 months. Quality of life was measured by web based QualityMetric’s SF12v2 Health Survey. Results: Of the 52 patients under assessment, significant improvement occurred in 40 patients (76.9%) and 40 patients (76.9%) presented normalization of their BUN and creatinine levels within 3 weeks Postoperative complications occurred in 28.46 of the patients. Mean survival at 6 and 12 months was, respectively, 48.07% and 23.07%. 4 patients developed VVF fistulas. Post procedure 15 patients 28.84% received palliative radiotherapy. There was considerable improvement in physical and emotional well being of the patients in 1st week,fourth week, and third month web based Quality Metric’s SF-12v2 Health Survey. Conclusion: In the present study we have concluded that the presence of malignant ureteric obstruction, palliative percutaneous urinary diversion may be performed and is effective in improving renal function. Urinary diversion by percutaneous
nephrostomy will definitely provide considerable physical and emotional wellbeing of the patient.
 


Keywords : Cervical cancer; Obstructive uropathy; Percutaneous nephrostomy.
Corresponding Author : Shaik Hussain Saheb