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World J Nephrol. Mar 6, 2016; 5(2): 172-181
Published online Mar 6, 2016. doi: 10.5527/wjn.v5.i2.172
Use of percutaneous nephrostomy and ureteral stenting in management of ureteral obstruction
Linda Hsu, Hanhan Li, Daniel Pucheril, Moritz Hansen, Raymond Littleton, James Peabody, Jesse Sammon
Linda Hsu, Hanhan Li, Daniel Pucheril, Raymond Littleton, James Peabody, Jesse Sammon, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI 48202-2689, United States
Moritz Hansen, Jesse Sammon, Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, ME 04101, United States
Author contributions: Hsu L and Li H contributed equally to the work; Hsu L, Li H, Pucheril D and Sammon J conceptualized and designed the review; Hsu L, Li H and Pucheril D drafted the initial manuscript; Hansen M, Littleton R, Peabody J and Sammon J provided critical revisions and supervised the writing process; all authors reviewed and approved the final manuscript as submitted.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jesse Sammon, DO, Vattikuti Urology Institute, Henry Ford Health System, 2799 West Grand Blvd, Detroit, MI 48202-2689, United States. jsammon79@gmail.com
Telephone: +1-207-6927167 Fax: +1-313-9164352
Received: August 24, 2015
Peer-review started: August 26, 2015
First decision: November 27, 2015
Revised: December 25, 2015
Accepted: January 21, 2016
Article in press: January 22, 2016
Published online: March 6, 2016
Processing time: 190 Days and 7.7 Hours
Abstract

The management options for ureteral obstruction are diverse, including retrograde ureteral stent insertion or antegrade nephrostomy placement, with or without eventual antegrade stent insertion. There is currently no consensus on the ideal treatment or treatment pathway for ureteral obstruction owing, in part, to the varied etiologies of obstruction and diversity of institutional practices. Additionally, different clinicians such as internists, urologists, oncologists and radiologists are often involved in the care of patients with ureteral obstruction and may have differing opinions concerning the best management strategy. The purpose of this manuscript was to review available literature that compares percutaneous nephrostomy placement vs ureteral stenting in the management of ureteral obstruction from both benign and malignant etiologies.

Keywords: Percutaneous nephrostomy; Urinary diversion; Ureteral obstruction; Quality of life; Ureteral stents; Pelvic malignancy; Urinary drainage

Core tip: Ureteral obstruction as a consequence of malignant or benign etiologies is a common urologic entity that is often challenging for clinicians to determine the optimal method of urinary decompression. There is no consensus on the use of stents vs percutaneous nephrostomy in the management of ureteral obstruction as well as a lack of clear superiority of stenting over percutaneous approach in terms of complications and quality of life considerations. Therefore, treatment decisions must be individualized using a multidisciplinary approach involving the patients, their family and members of the treatment team.