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Quality of life with tandem ureteral stents compared to percutaneous nephrostomy for malignant ureteral obstruction

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Abstract

Purpose

Malignant ureteral obstruction (MUO) is treated with kidney decompression by a percutaneous nephrostomy (PCN) or internal ureteral stents. The objective of this study was to compare quality of life (QoL) with a PCN compared to tandem ureteral stents (TUS) in cases of MUO.

Methods

We reviewed the medical records of patients with MUO who were treated by PCN/TUS in our institution between June 2019 and May 2020. Patients were asked to fill out a QoL questionnaire, a tube-symptoms questionnaire, report a general health scale, and asked for a drain preference if they had experience with both drains. Scores of both groups were compared and predictors of all QoL and tube-symptoms measures were searched using multivariate analysis.

Results

Seventy-four patients with a PCN and 30 with TUS were included in the study. No statistically significant difference was found in all QoL and tube-symptoms measurements between the two drains. Type of drain was not found to be a predictor of QoL or tube-related symptoms. Eighty-four percent of patients (11/13) who have experience with both types of drains preferred TUS.

Conclusion

TUS and PCN for relief of MUO have a negative and similar effect on various areas of QoL and urinary symptoms. Most patients who had experience with both types of drains preferred TUS over PCN. In this patient population with a grim prognosis, this negative effect must be communicated to patients, and calculated against the potential benefits of drainage.

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Author information

Author notes

  1. Asaf Shvero and Miki Haifler contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, Sheba Medical Center, Ramat-Gan, Israel

    Asaf Shvero, Miki Haifler, Husny Mahmud, Zohar Dotan, Harry Winkler & Nir Kleinmann

  2. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Asaf Shvero, Miki Haifler, Husny Mahmud, Zohar Dotan, Harry Winkler & Nir Kleinmann

Authors
  1. Asaf Shvero
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  2. Miki Haifler
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  3. Husny Mahmud
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  4. Zohar Dotan
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  5. Harry Winkler
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  6. Nir Kleinmann
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Contributions

AS: conceptualization, methodology, formal analysis, writing—original draft. MH: methodology, formal analysis, writing—review and editing. HM: data curation. ZD: writing—review and editing, project administration, supervision. HW: conceptualization, writing—review and editing. NK: conceptualization, methodology, writing—review and editing, project administration, supervision.

Corresponding author

Correspondence to Asaf Shvero.

Ethics declarations

Ethics approval

This study was approved by the institutional research ethics committee in Sheba Medical Center. This study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Competing interests

The authors declare no competing interests.

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Appendices

Appendix 1

Table 5 EQ-5D-5L Quality of Life Questionnaire
Full size table

Appendix 2

Table 6 Tube symptoms questionnaire
Full size table

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Shvero, A., Haifler, M., Mahmud, H. et al. Quality of life with tandem ureteral stents compared to percutaneous nephrostomy for malignant ureteral obstruction. Support Care Cancer 30, 9541–9548 (2022). https://doi.org/10.1007/s00520-022-07354-2

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  • DOI: https://doi.org/10.1007/s00520-022-07354-2

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