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[Palliative urinary diversion in inoperable pelvic tumors]
J F Olivo1, L Le Joliff, J Artagnan
1Service d'Urologie, CHU Pontchaillou, Rennes.
Journal D'Urologie
|January 1, 1987
Summary
Palliative urinary diversion via cutaneous ureterostomy in advanced pelvic cancers offers limited survival benefits and quality of life. Epidural morphine may improve patient comfort, addressing a key limitation of this procedure.
Area of Science:
- Urology
- Oncology
- Palliative Care
Context:
- Malignant pelvic tumors can cause bilateral ureteric obstruction.
- Palliative urinary diversion is considered when curative options are exhausted.
- Advanced pelvic carcinomas, particularly in women, present a rare but challenging clinical scenario.
Purpose:
- To evaluate the legitimacy and outcomes of palliative urinary diversion in patients with advanced pelvic malignancies.
- To assess the effectiveness of cutaneous ureterostomy in managing ureteric obstruction.
- To explore factors influencing survival and quality of life in this patient group.
Summary:
- A retrospective review of 39 patients undergoing cutaneous ureterostomy for pelvic cancer-related obstruction was conducted.
- The mean survival was 225 days, with only 25% experiencing good or satisfactory quality of life.
- Alternative techniques like J-catheter and percutaneous nephrostomy have limitations in specific clinical situations.
Impact:
- Findings question the routine use of cutaneous ureterostomy due to poor outcomes.
- Suggests that pain management, potentially with epidural morphine, could improve quality of survival.
- Highlights the need for careful patient selection and consideration of alternative palliative strategies.