Palliative nephrostomy for relief of ureteral obstruction secondary to malignancy

A mean survival of 7.6 months in 20 patients undergoing nephrostomy for relief of ureteral obstruction from advanced pelvic malignancy was not as dismal as previous reports have indicated. Patients with bilateral ureteral obstruction from direct extension of pelvic malignancy survived considerably longer and appear to be the best candidates for nephrostomy. The physician must be cautious in advising the procedure to patients with bilateral ureteral obstruction from disseminated disease originating outside the pelvis since mean survival in this group (3 patients) was less than one month. Nephrostomies were associated with a significant incidence of perinephric abscess (15 per cent) emphasizing the technical aspect of accurate placement to avoid leakage of potentially infected urine.