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Nephrostomy insertion for patients with bilateral ureteric obstruction caused by prostate cancer

¹ St Helier Hospital, Carshalton, Surrey, ² Guy's Hospital, London, ³ East Surrey Hospital, Redhill, ⁴ Epsom and St Helier NHS Trust, Epsom, Surrey, UK

Correspondence: Joseph Nariculam, Flat 3, Lodden Lodge, 10 Devonshire Avenue, Sutton SM2 5JL, UK. E-mail: jnariculam{at}yahoo.co.uk

Ureteric obstruction causing renal failure is a serious complication of advanced prostate cancer. Percutaneous nephrostomies (PCNs) are used to decompress the obstructed kidney(s). This study aims to identify whether bilateral PCN insertion confers any advantage over unilateral PCN insertion for patients with bilateral ureteric obstruction. In a cohort of 25 patients, 18 underwent bilateral and 7 underwent unilateral PCN insertion. The mean survival time following PCN was 7.5 months for all patients. The data suggest that the nadir serum creatinine after PCN insertion was similar, independent of whether one or two nephrostomies were inserted. There was also little difference in the serum creatinine levels at the time of death, suggesting that survival after PCN insertion is based on the aggressiveness of the prostate cancer as opposed to the number of nephrostomies inserted.