Obstructive Uropathy (OU) is the partial or complete blockage of urinary flow with secondary reduction in kidney function. This can be unilateral or bilateral and can be acute or chronic. If left untreated, acute OU can result in death from sepsis or irreversible renal damage[1]. Definitive treatments for relief of ureteric obstruction vary locally and the choice of management may depend on the presumed aetiology and the patient’s medical condition. The aim of this analysis was to ascertain the rates of different management pathways and...

Data was obtained retrospectively over a 12-month period (July 2017 to June 2018) from local radiology, biochemistry and theatre patient databases. Only admissions with acute obstructive uropathy were included. Admissions for routine exchange or removal of nephrostomy/stent as well as routine urology/stone management were excluded. Analysis of the data against agreed local recommendations was conducted (Fig. 1). Information regarding level of obstruction wasdocumentedin patients only if clearly stated in the procedure report or coincident imaging. Sepsis was identified in patients where all the following parameterswere...

Of the 249 patients with acute OU, 195 (78%) had primarynephrostomy and/orantegrade ureteric stent and 54 (22%) had primary retrograde ureteric stent. The distribution of indications for nephrostomy, antegrade and retrograde ureteric stents is displayed in Fig. 2. Patient characteristics and outcomes are displayed in Table 1. Observed frequencies of management pathways across the categories of sepsis and level of obstruction were statistically significant (p

The majority of patients with acute OU were managed with primarynephrostomyand/or antegrade ureteric stent. Patients managed with primary nephrostomy and/or antegrade ureteric stent were older, more clinically unwell, had longer lengths of inpatient stay and were more likely to die. Patientsmanaged withprimary retrograde ureteric stentwere younger, fitter, more likely to have simple stone disease and went home sooner. As expected, septic patients and those with distalobstructive uropathywere more likely to be managed with primarynephrostomy and/or antegrade ureteric stent. A small number of patients hadnephrostomy placed...

H. Komber; Bristol/UK - nothing to disclose G. Collin; Bristol/UK - nothing to disclose

1. BMJ Best Practice: Obstructive Uropathy. 2018. [Online]. Available from:https://bestpractice.bmj.com/topics/en-us/643