CLINICAL OUTCOMES OF MALIGNANT URETERAL OBSTRUCTION: INSIGHTS FROM AHSANIA MISSION CANCER AND GENERAL HOSPITAL

Abstract

Background: Malignant ureteral obstruction (MUO) is a severe complication caused by primary or metastatic malignancies compressing or invading the ureters. Management options include percutaneous nephrostomy (PCN) and ureteral stenting. However, clinical outcomes depend on tumor burden, response to oncologic treatment, and patient performance status. Aim of the study: The aim of this study was to assess the clinical outcomes of malignant ureteral obstruction. Methods: This cross-sectional study was conducted in Department of General Surgery, Ahsania Mission Cancer and General Hospital, Dhaka, Bangladesh, during the period from January 2024 to December 2024 (1 Year). Total 36 patients diagnosed with malignant ureteric obstruction (MUO) were included in this study. Result: The study population (N=36) had a mean age of 60.5 ± 9.3 years, with a male predominance (61.11%). Bladder cancer (33.33%) was the most common malignancy. Advanced-stage disease (T4: 55.56%) and bilateral obstruction (41.67%) were prevalent, indicating severity. Baseline renal function showed moderate to severe impairment (creatinine: 2.5 ± 0.8 mg/dL, eGFR: 45.6 ± 12.3 mL/min/1.73m²). Intraoperatively, ureteric stenting (61.11%) was more common than PCN (38.89%), with a high success rate (91.70%). Blood loss was minimal, and complications were low. Postoperatively, mortality was 8.33%. Complications occurred in 27.78% of cases, with infection (11.11%) being the most frequent. At six months, renal function slightly declined, and intervention durability dropped to 80.20. Conclusion: This study highlights the clinical impact of malignant ureteric obstruction (MUO), demonstrating initial renal function improvement post-intervention, but progressive deterioration over time.