Nonoperative urinary diversion for malignant XXXX .

@entity1 @entity1901 @entity1695 @entity5 @entity177
The management of malignant @entity1695 (MUO) has undergone major changes due to the availability of percutaneous drainage techniques and new ureteral stents for endoscopic insertion. These procedures are less morbid than conventional surgical techniques so that the indications for urinary diversion due to untreated or relapsing @entity5 have to be reconsidered. During the period of technological change from 1978 to 1984, 135 @entity1 with unilateral (37) or bilateral (98) MUO were managed. Open nephrostomy is now almost never necessary. Initial retrograde ureteral stenting (RS) was successful under local anaesthesia in 41% of @entity1 . Forty-seven had percutaneous nephrostomy (PN), nine of whom underwent @entity1901 ( @entity1901 ) and elimination of external appliances. Twenty-nine @entity1 underwent miscellaneous open procedures mostly in the earlier years, with a 57% morbidity rate compared to the minimal morbidity associated with the newer techniques. The overall mean survival post diversion was 9.9 months, which is significantly longer than that reported using open procedures. MUO can now be successfully relieved with little morbidity and frequently without the use of external urine collection devices. The relative ease of diversion can complicate decision making in @entity1 with progressive @entity177 due to bilateral MUO.
