The efficacy of double percutaneous nephrostomy combined with ureter occlusion stent in treating cervical cancer complicated with vesicovaginal fistula after radiotherapy

Objective: To evaluate the efficacy of double percutaneous nephrostomy combined with ureter occlusion stent in treating cervical cancer complicated with vesicovaginal fistula after radiotherapy. Method: A prospective analysis was taken for 12 patients with cervical cancer complicated with vesicovaginal fistula after radiotherapy who were diagnosed by gynecological examination, imaging and cystoscopy. All patients received concurrent double percutaneous nephrostomy and ureter occlusion stent implantation. The improvement of symptoms and postoperative complications were observed. The number of white blood cells in urine, renal function, number of diapers in daily use (pieces), daily vaginal and urethral exudate, pain score, physical status (ECOG) score and quality of life score (KPS) before and 7 d after the procedure were compare by the paired Student's t test. Results: Twelve patients were successfully implanted 24 ureter occlusion stents after successful nephrostomy. Postoperatively, urinary fistula immediately disappeared in all patients. One week after operation, bilateral hydronephrosis disappeared in 4 patients, renal insufficiency and renal function returned to normal in 4 patients. There were significant differences in the number of white blood cells in urine, the number of diapers in daily use, the daily vaginal and urethral exudate, pain score, KPS and ECOG score compared with before and 7 d after the procedure (all P < 0.05). There was no significant difference in the creatinine and urea nitrogen (all P > 0.05). No serious complications occurred after the operation. Conclusion: Double percutaneous nephrostomy combined with ureter occlusion stent can effectively and safely treat cervical cancer complicated with vesicovaginal fistula after radiotherapy. (authors)