Antegrade Double-J Stent Placement for the Treatment of Malignant Obstructive Uropathy

Antegrade Double-J Stent Placement for the Treatment of Malignant Obstructive Uropathy: a Single Center Experience

Ureteral double- J stent is usually inserted by retrograde approach for the treatment of obstructed upper urinary tract. The antegrade approach, can a suitable alternative in certain situations without the need for general or spinal anesthesia. The present study demonstrates the indications, success rate, and complications of this approach in the treatment of malignant obstructive uropathy.

Study Overview

• Status: Completed
• Conditions: Urologic Neoplasms
• Intervention / Treatment: Procedure: Antegrade double-J stent

Detailed Description

Data of consecutive patients in whom antegrade ureteral stent¬ing was performed between January 2013 and February 2020 were retrospectively analysed using patient records and radiology reports. A total of 174 patients (sexe ratio = 0.51, age range 9-91 years; mean age, 54 years) were included in the study.

Ureteral obstruction was caused by bladder cancer (n=92), uterin cancer (n=31), prostate cancer (n=28), colorectal cancer (n= 15) and retroperitoneal tumor (n= 8) (Table 1).

• Study Type: Observational
• Enrollment (Actual): 174

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: N/A
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

A total of 174 patients (sexe ratio = 0.51, age range 9-91 years; mean age, 54 years) were included in the study.

Description

Inclusion Criteria:

• malignant uropathy obstruction

Exclusion Criteria:

• benign uropathy obstruction

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Retrospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

malignant uropathy; Antegrade double-J stent

Procedure: Antegrade double-J stent; After exchanging the nephrostomy catheter over the J-tipped guidewire, 5 F multipurpose (45° tip) diagnostic vascular catheter was inserted. Once the pelvi¬ureteric junction was crossed and the ureter accessed, a straight hydrophilic guidewire and a catheter were used. Then, the cath-eter was advanced into the bladder over the wire, this guidewire was exchanged for an ultra-stiff guidewire, an 8 or 10 F double J ureteral stent was placed over the guidewire, and the safety kit of the stent was removed. A final fluoroscopic image was stored for correcting the stent position.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
number of patient having Antegrade double-J stent placement for the treatment of malignant obstructive uropathy	double j stent placement succeed or failed	7 years

Collaborators and Investigators

• Sponsor: Université de Sousse
• Investigators: Study Director: ghaassen tlili, PROFESSOR, university of sousse

Publications and helpful links

General Publications

• Tlili G, Ammar H, Dziri S, Ben Ahmed K, Farhat W, Arem S, Acacha E, Gupta R, Rguez A, Jaidane M. Antegrade double-J stent placement for the treatment of malignant obstructive uropathy: A retrospective cohort study. Ann Med Surg (Lond). 2021 Aug 16;69:102726. doi: 10.1016/j.amsu.2021.102726. eCollection 2021 Sep.

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2013
• Primary Completion (Actual): June 29, 2017
• Study Completion (Actual): February 2, 2020

Study Registration Dates

• First Submitted: November 24, 2020
• First Submitted That Met QC Criteria: November 24, 2020
• First Posted (Actual): December 2, 2020

Study Record Updates

• Last Update Posted (Actual): December 4, 2020
• Last Update Submitted That Met QC Criteria: December 2, 2020
• Last Verified: December 1, 2020

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neoplasms; Urogenital Neoplasms; Neoplasms by Site; Urologic Neoplasms
• Other Study ID Numbers: U23459

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Undecided

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No