PALLIATIVE PERCUTANEOUS AND ENDOSCOPIC URINARY-DIVERSION FOR MALIGNANT URETERAL OBSTRUCTION

We performed a retrospective analysis of 22 patients with malignant ureteral obstruction who underwent palliative urinary diversion by retrograde ureteral stenting or nephrostomy tube placement. The average duration of survival after diversion was 526 days and was unrelated to tumor type, patient's age or sex, renal function, or indications for diversion. As a group, patients without previous hormonal or chemotherapy survived longer. Morbidity related to the urinary diversion was low. The majority of patients (77%) were discharged from the hospital, and this group spent 86 percent of their survival time at home. We conclude that modern palliative urinary diversion can be performed with low morbidity and can result in long-term survival and improved quality of life. Predictions or assumptions concerning survival of individual patients should be made with caution.