Outcomes of Ultrasound-Guided Percutaneous Nephrostomy in Carcinoma Cervix with Upper Tract Obstruction

Abstract

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. 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. 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. Percutaneous nephrostomy is a safe and effective procedure in advanced cancer cervix with obstructive uropathy.