Ureteral obstruction: New trends in management

Ureteral obstruction is blockage in one or both of the tubes (ureters) that carry urine from the kidneys to the bladder which is a potential common cause of reversible renal injury. It can be caused by benign or malignant pathologies. Decompression of the obstruction is considered a vital step in management. Percutaneous nephrostomy (PCN) and ureteral stenting are the two common diversion surgical techniques used for the treatment of obstruction. In cases of benign ureteric obstruction, the choice between PCNor stenting is highly arguable among urologists and is dependent on factors such as the cause, severity of obstruction availability of treatment modalities, and surgeon experience, and both techniques are considered similar successful in treating such case. For ureteric stones, urologists typically try stenting first and resort to PCNif stenting fails. The choice between the two is dependent on the availability of resources and surgical experience. On the other hand, PCNis the preferred initial method in cases of malignant obstruction because of high late failure rates in cases of ureteral stenting. Percutaneous nephrostomy cases had the drawback of the need for a collection instrument placed externally which impacted the patient’s life.