Urinary diversion in children with pelvic tumors.

Abstract

PURPOSE:

The aim of this study was to investigate children presenting with malignant pelvic tumors obstructing the upper urinary tract.

METHODS:

Seventeen children with upper urinary tract obstruction by a malignant tumor were reviewed. A nephrostomy tube or Double J (DJ) stent was inserted into each obstructed urinary system and removed after tumor shrinkage and/or hydronephrosis regression.

RESULTS:

There were 9 boys and 8 girls in the study; the mean age and median follow-up were 5.7 years and 2.5 years, respectively. The most common obstructing tumor was rhabdomyosarcoma. Twelve children underwent diversion by nephrostomy tubes and 3 by DJ stents; 2 patients underwent resection of the tumors with ureteroureterostomy. Complications after the insertion of the stents included febrile urinary tract infections (UTI) or pyelonephritis in 4 of the children with DJ stents. In the nephrostomy group, febrile UTI developed in 3 and the tube fell out in 1, and was blocked in another. Of the 17 children, 9 have no evidence of disease, 2 are currently under treatment, and 6 died of cancer.

CONCLUSIONS:

The prognosis of children with malignant pelvic tumor obstructing the upper urinary system justifies urgent and optimal upper tract diversion, enabling chemotherapy to be started immediately.

• Authors: D Ben Meir, M Inoue, U Gur, P M Livne, Y Yaniv, K Tiedeman, D M Ashley, J M Hutson
• Journal: Journal of pediatric surgery (J Pediatr Surg) Vol. 39 Issue 12 Pg. 1787-90 (Dec 2004) ISSN: 1531-5037 [Electronic] United States
• PMID: 15616930 (Publication Type: Journal Article)

Topics

• Child, Preschool
• Female
• Follow-Up Studies
• Humans
• Male
• Pelvic Neoplasms (complications)
• Ureteral Obstruction (etiology, surgery)
• Urinary Diversion