Percutaneous nephrostomy in malignant ureteric obstruction

Objective: To assess survival length and quality of life in patients with a percutaneous nephrostomy (PN) for malignant tumour and postrenal anuria. Patients and methods: Case records were analysed of 50 patients (39 men, eleven women; mean age 65.6 years) with postrenal anuria due to malignancy who had undergone ultrasound-directed PN under local anaesthesia for urinary drainage. Particular attention was paid to the course of the disease from nephrostomy until death. Results: Survival time after PN ranged from 4 days to 16 months, averaging 4.3 months. 26 patients (52%) had died after 3 months, 41 (82%) after 6 months. The patients had spent on average 44.5% of their remaining life in hospital. After an initial improvement in their state, cancer-produced pain and complications soon set in and often required operative intervention. Conclusion: The achieved prolongation of survival time did not always meet the patient's own wishes. Detailed explanation and information to patient and family before PN is therefore urgently required.