Outcomes of Ultrasound-Guided Percutaneous Nephrostomy in Carcinoma Cervix with Upper Tract Obstruction
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ORIGINAL ARTICLE
Outcomes of Ultrasound-Guided Percutaneous Nephrostomy in Carcinoma Cervix with Upper Tract Obstruction Ramanitharan Manikandan1 • Kavita Mahadevappa2 • Lalgudi Narayanan Dorairajan1 Sunil Kumar3 • Sreerag K. Sreenivasan1 • Sidhartha Kalra1
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Received: 20 September 2020 / Accepted: 9 November 2020 / Published online: 23 November 2020 Ó Association of Gynecologic Oncologists of India 2020
Abstract Background Cancer cervix is the fourth most common cancer and a fourth common cause of cancer mortality in women worldwide. In India, cervical cancer is the second most common cancer among women and approximately 70% of patients present at an advanced stage with one-third of them in obstructive uropathy. The present study aims to analyze the outcomes of percutaneous nephrostomy (PCN), as a urinary diversion technique, in advanced cancer cervix. Methods All patients with advanced cancer cervix with bilateral hydronephrosis or unilateral hydronephrosis with elevated serum creatinine ([ 1.4 mg/dl) who underwent PCN in the Department of Urology, JIPMER, between November 2014 and December 2016 were included in the study in a prospective manner. The change in blood urea and serum creatinine levels was estimated by paired t test. The complications were graded according to the modified Clavien classification system. Results A total of 368 patients underwent PCN in the study period out of which 133 were due to cancer cervix. There were no failure or intraoperative complications during the procedure. There were no deaths noted until the follow-up period of 30 days. Only two patients developed sepsis. Out of 20 (15%) patients who developed haematuria, four (20%) required blood transfusion and was self-limiting in 16 (80%) patients. Reinsertion of PCN was required in 11 patients within a month. Conclusions Percutaneous nephrostomy is a safe and effective procedure in advanced cancer cervix with obstructive uropathy. Keywords Cancer cervix Obstructive uropathy Percutaneous nephrostomy Uraemia
Introduction
& Kavita Mahadevappa [email protected] Ramanitharan Manikandan [email protected] Lalgudi Narayanan Dorairajan [email protected] Sreerag K. Sreenivasan [email protected] Sidhartha Kalra [email protected] 1
Department of Urology, JIPMER, Pondicherry 605006, India
2
Department of OBG, KIMS, Hubli, Karnataka 580021, India
3
Department of Urology, AIIMS, Rishikesh 249203, India
Cancer cervix is the fourth most common cancer and a fourth common cause of cancer mortality in women worldwide. The worldwide incidence of cervical cancer is approximately 5,69,847 new cases annually, with nearly 3,11,365 deaths worldwide [1]. About 80% of cancer cervix occurs in developing countries. In India, cervical cancer is the second most common cancer among women and accounts for nearly one-fifth of the global cervical cancer burden [1]. Around 70% of patients present at an advanced stage, with one-third of them in obstructive uropathy [2]. The etiology of obstructive uropathy is postulated to direct m
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