Hydronephrosis in malignant tumors: rationale and efficiency of endo-urological diversions

The improvement of minimal invasive endo-urological urinary diversions in patients with malignant ureteral obstruction (MUO) provides an alternative to open surgery. Endo-urologic procedures cause less morbidity than conventional surgical techniques. From April 1986 to April 1989, 52 patients suffering from MUO representing 64 reno-ureteral units were treated by endo-urological diversions. Proper drainage was achieved in all cases. Initial retrograde JJ-stenting was successfully performed in 30 instances. Percutaneous nephrostomy tubes were primarily placed in 34 units. Fourteen of these were finally changed to a JJ-stent in eleven cases and an ileal conduit in three. Percutaneous ureteral occlusion was performed in 7 units. A positive response regarding the effect of endo-urological treatment on the patient's quality of life was obtained in 81%. Further therapies of the underlying diseases were performed in more than 30% after stabilized renal function. MUO can be treated in most cases with little morbidity and frequently without the use of external collecting devices.