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Ureteric obstruction after radical hysterectomy.
A.A.W. Peters1, G.M. Beekman, P.J. Bode
1Departments of Gynecology, Radiology, Urology and Clinical Oncology-Radiotherapy, Leiden University Medical Center, the Netherlands.
Summary
Invasive cervical cancer patients experiencing ureteric obstruction after radical hysterectomy may benefit from a conservative
Area of Science:
- Gynecologic Oncology
- Urology
- Nephrology
Background:
- Radical hysterectomy for invasive cervical cancer can lead to postoperative ureteric obstruction.
- Ureteric obstruction poses a risk to renal function if not managed promptly.
Purpose of the Study:
- To evaluate the efficacy of a 'wait and see' approach for postoperative ureteric obstruction following radical hysterectomy.
- To determine the potential for spontaneous resolution of ureteric obstruction in this patient population.
Main Methods:
- Case study of two patients with invasive cervical cancer who underwent radical hysterectomy.
- Temporary percutaneous nephrostomy insertion to preserve renal function.
- Adjuvant radiotherapy was administered, delaying ureteric reimplantation.
Main Results:
- Both patients experienced spontaneous ureteric passage after 5 and 14 weeks, respectively.
- Percutaneous nephrostomy effectively preserved renal function during the observation period.
Conclusions:
- A 'wait and see' policy, with vigilant monitoring and supportive nephrostomy, may be a viable option for ureteric obstruction of unclear etiology post-radical hysterectomy.
- This conservative approach can be considered for at least 3 months, provided renal function is maintained.