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Hydronephrosis in patients with cervical cancer: an improved stent-change therapy for ureteral obstruction Stent-change for ureteral obstruction in cervical cancer

  • Author Footnotes
    # The authors contributed equally.
    Jie Li
    Footnotes
    # The authors contributed equally.
    Affiliations
    Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, Jiangsu, China
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  • Author Footnotes
    # The authors contributed equally.
    Haiming Cao
    Correspondence
    Corresponding authors at: Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, Jiangsu, China, Department of Andrology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
    Footnotes
    # The authors contributed equally.
    Affiliations
    Department of Andrology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
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  • Kang Peng
    Affiliations
    Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, Jiangsu, China
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  • Renfu Chen
    Affiliations
    Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, Jiangsu, China
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  • Xiaolei Sun
    Correspondence
    Corresponding authors at: Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, Jiangsu, China, Department of Andrology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
    Affiliations
    Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, Jiangsu, China
    Search for articles by this author
  • Author Footnotes
    # The authors contributed equally.
Published:January 24, 2023DOI:https://doi.org/10.1016/j.ejogrb.2023.01.026

      Abstract

      Objective

      Ureteral stent replacement is a routine treatment for hydronephrosis in patients with cervical cancer. We developed an improved ureteral stent-change operation for hydronephrosis in cervical cancer patients and compared its outcomes with traditional stent change procedures.
      Study design
      Clinical data of hydronephrosis in cervical cancer patients who were admitted to our hospital from August 2014 to October 2019 were analyzed. We retrospectively reviewed 131 cervical cancer patients, out of which 43 cases included patients in the improved operation group, whereas 88 patients with hydronephrosis followed the traditional ureteral stent-change operation for ureteral obstruction. The outcomes of the two procedures were compared using the propensity score matching method.

      Results

      As opposed to the traditional ureteral stent change strategy, the patients in the improved group required shorter operation time (p=0.001) and higher success rate (p= 0.004). The FIGO stage (p=0.046), the level of ureteral obstruction (p=0.027), radiotherapy history (p=0.01), stent replacement times (≤2times or>2times) (p=0.001), and serum creatinine level (≤200μmol/L or>200μmol/L) (p<0.001) were significantly different between the two groups before propensity score matching. Propensity score matching analysis was used to eliminate the clinical differences of 43 patients in the traditional group; however, the span of visual hematuria during the surgical complications was not included (p=0.026) in the results.

      Conclusion

      An improved ureteral stent change operation is an advanced treatment option for cervical cancer patients suffering from hydronephrosis. In contrast to traditional ureteral stent change techniques, our developed strategy lowers complications such as visual hematuria but improves the success.

      Abbreviations:

      HPV (Human Papilloma Virus), BMI (Body Mass Index), CT (Computed Tomography), MRI (magnetic resonance imaging), FIGO (Federation International Gynecology and Obstetrics), KUB X-ray (Kidney-Ureter-Bladder X-ray), IBM Corp (International Business Machines Corporation)

      Keywords

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