Palliative care in bilateral malignant ureteric obstruction

Bilateral ureteric obstruction is an uncommon complication arising from malignancy and its treatment. There are several effective methods of overcoming the obstruction but the choice of option requires careful consideration of various factors pertaining to each individual. These factors include the patient's age, premorbid health and lifestyle, and the extent and rate of disease. Patient and family expectations, goals and priorities need careful consideration in the context of the patient's prognosis. If measures to relieve the obstruction are not to be undertaken, symptom control then becomes paramount. This paper explores the various options and decision making by focusing on representative patients encountered in the practice of the Central Sydney Area Health Palliative Care Service.