Abstract:Objective: To investigate the efficacy of urological management for ureteral obstruction in patients with gynecological tumors. Methods: Fifty-six patients with ureteral obstruction secondary to gynecological tumors were treated with indwelling retrograde or prograde ureteral double-J stents, or with percutaneous nephrostomy. Results: Thirty-five patients had unilateral ureteral obstruction and 29 cases of catheterization succeeded initially (82.9%). Twenty-one patients had bilateral ureteral obstruction and 28 sides of catheterization succeeded initially (66.7%). After the catheterization the hydronephrosis was improved and the serum creatinine levels were lowered form 178 to 115 μmol/L. Twelve patients who had successful stenting presented with stent failure in 1 week to 6 months after the initial catheterization. The stents were replaced successfully in 9 of them. Forty-six patients were followed-up for 3 to 36 months. Twenty patients (43.5%) died from advanced gynecological tumors. In the remaining 26 patients, 18 continued their treatment with ureteral stents. The patients accepted percutaneous nephrostomy or watchful waiting after the failure of catheterization. No severe complications associated with the procedures occurred. Conclusions: Indwelling double-J stents can be considered as the first-line treatment in patients with ureteral obstruction secondary to gynecological tumors. Individualized treatment should be selected in patients with catheterization failure.
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