Evidence map›Paper›PMID 35084651›Full record

ArticleInternational urology and nephrology2022

Evaluation of Galdakao-modified Valdivia position in endoscopic management of malignant ureteric obstruction.

Ahmed Emam, Mohamed Elmoazen, Mohamed Shabayek, Amr M Zriek, Hany Hamed Gad

Open access · hybridAbstract read
In one paragraph

Article in International urology and nephrology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Ahmed EmamDepartment of Urology, Ain Shams University, 38 Abbasia, Cairo, 11591, Egypt. Ahmed_emam@med.asu.edu.eg.ORCID http://orcid.org/0000-0002-7677-0461
Mohamed ElmoazenDepartment of Urology, Ain Shams University, 38 Abbasia, Cairo, 11591, Egypt.
Mohamed ShabayekDepartment of Urology, Ain Shams University, 38 Abbasia, Cairo, 11591, Egypt.
Amr M ZriekDepartment of Urology, Ahmed Maher Teaching Hospital, Cairo, Egypt.
Hany Hamed GadDepartment of Urology, Ain Shams University, 38 Abbasia, Cairo, 11591, Egypt.
Ain Shams University · EGResearch Institute of Ophthalmology · EG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMalignant ureteric obstruction (MUO) due to pelvic malignancies is challenging for endourological management and carries high failure rates for retrograde cystoscopic ureteric stenting.

methodsWe adopted Galdakao-modified Valdivia (GMV) position in the management of MUO in an operating room equipped with a C-arm fluoroscopy unit and an ultrasound device. We prospectively studied the added value of this approach in 50 cases who failed retrograde ureteric stenting.

resultsThirty-seven (74%) cases were done under a high level of spinal anesthesia. Mean operative time was 62 min. Antegrade ureteric stenting succeeded in 45/50 (90%) patients who failed retrograde ureteric stenting. GMV position facilitated simultaneous retrograde and antegrade management of MUO. Eight patients (16%) underwent auxiliary cystoscopic procedures to reduce the mass over the ureteric orifice (UO) guided by antegrade methylene blue or over a probing antegrade guidewire. Nephrostomy tube was inserted in the same setting in 16/50 (32%) cases. Antegrade flow of contrast to the bladder (P < 0.001) and ureteric kinks rather than tight stenosis or infiltration of UO (P = 0.014) were significantly associated with the success of antegrade ureteric stenting. No major complications were encountered.

conclusionGMV position is an ideal choice for management of MUO as it allows simultaneous access to the lower and the upper urinary systems to accomplish ureteric stenting either in a retrograde or an antegrade fashion as well as the ability to insert a nephrostomy tube in the same setting, thus shortening the inpatient care and this should be the standard of care in cases with MUO.

Indexed as

UreteroscopyAdultAgedFemaleHumansMaleMiddle AgedPatient PositioningProspective StudiesUreteral ObstructionYoung AdultAntegrade ureteric stentingGaldakao-modified Valdivia positionMalignant ureteric obstructionUreteric obstructionUreteric stenting

Identifiers

PMID35084651
PMCPMC8831257
OpenAlexW4210588794

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.