DJ-STENTING

EFFICACY IN THE MANAGEMENT OF OBSTRUCTIVE UROPATHY

Abstract

Background: Obstructive Uropathy is a serious urological emergency. Upper tract Obstruction when it is bilateral or in solitary functioning kidney can lead to renal Impairment resulting in oliguria and anuria. Dialysis or Urinary Diversion by PCN and Retrograde Stenting is required. Purpose of this study was to prove the efficacy of DJ Stenting in cases of obstructive uropathy. D J Stenting overcomes the Emergency and elective definite treatment can be planned when patient is fairly fit and renal functions have come to normal. Study design: It was retrospective, convenient and descriptive type of study. Material and Method : It comprised of 33 cases of obstructive uropathy presented in urology department of PIMS Islamabad from 2001 to 2002 .Patients with Bladder and Prostate Malignancy and other causes of infra vesical obstruction were excluded from study. Results: Male to female ratio was 1.4:1 .Age ranged from 25 to 70 years Pain alone or Pain with Oliguria and Anuria was the major presentation. Stone disease was the cause in 31(93.93%) patients. Serum creatinine was >10 mg/dl in 15 case (45.45 %) preoperatively. Stenting was done in 10 cases bilaterally and in 23 cases unilaterally. Postoperatively creatinine became normal in 10 cases (30.30%) and reduced to range of 1.2 to 2 mg/dl in 8 cases(24.24%). So 54.54% improved dramatically. Hospital stay was one week in in 22 cases (66.66%)and >one week in
11 cases. Ten cases required dialyses preoperatively. Conclusion: Retrograde stenting is an easy procedure for the management of obstructive uropathy required no general or regional anesthesia and external ports.