Materiały źródłowe

• #1 Ureteral obstruction – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ureteral-obstruction/symptoms-causes/syc-20354676

  A ureteral obstruction is a blockage in one or both of the tubes (ureters) that carry urine from the kidneys to the bladder. Ureteral obstruction can be cured. However, if it’s not treated, symptoms can quickly move from mild pain, fever and infection to severe loss of kidney function, sepsis and death. […] Ureteral obstruction can lead to urinary tract infections and kidney damage, which can be irreversible. […] Ureteral obstruction care at Mayo Clinic.

• #2 Ureteral obstruction | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/ureteral-obstruction?content_id=CON-20208697

  A ureteral obstruction is a blockage in one or both of the tubes (ureters) that carry urine from the kidneys to the bladder. Ureteral obstruction can be cured. However, if it’s not treated, symptoms can quickly move from mild pain, fever and infection to severe loss of kidney function, sepsis and death. […] Ureteral obstruction can lead to urinary tract infections and kidney damage, which can be irreversible. […] The goal of ureteral obstruction treatment is to remove blockages, if possible, or bypass the blockage, which may help repair damage to the kidneys. Treatment might include antibiotics to clear associated infections. […] A ureteral obstruction that causes severe pain might require an immediate procedure to remove urine from your body and temporarily relieve the problems caused by a blockage. […] There are a number of surgical procedures used to correct ureteral obstructions. The type of procedure depends on your situation. […] Your doctor (urologist) determines the type of procedure and the best surgical approach to treat your condition.

• #3

  https://www.aurorahealthcare.org/services/urology/ureteral-obstruction

  Ureteral obstructions are blockages in your urinary tract, which includes your kidneys, bladder, the tubes that carry urine from your kidneys to your bladder (ureters), and the tube that connects your bladder to the outside of your body (urethra). […] Obstructions can be cured with surgery, but they need to be treated promptly. If theyre not, they can lead to severe illness, kidney damage and life-threatening infections. […] After youve been diagnosed, your doctor will work with you on a treatment tailored to your needs. Your treatment will likely involve surgery to remove blockages and repair any damage to your ureters and kidneys. […] Before your surgery, you may need temporary treatment to help your body get rid of urine. This could include: A catheter: Your doctor inserts a tube through your urethra into your bladder to drain urine. A ureteral stent: Your doctor inserts a tube into one or both of your ureters to help keep them open. Percutaneous nephrostomy: Your doctor inserts a tube through your back into your kidneys to drain them.

• #4 Ureteral obstruction // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/ureteral-obstruction

  Ureteral obstruction can be cured. However, if it’s not treated, symptoms can quickly move from mild pain, fever and infection to severe loss of kidney function, sepsis and death. […] Ureteral obstruction can lead to urinary tract infections and kidney damage, which can be irreversible. […] The goal of ureteral obstruction treatment is to remove blockages, if possible, or bypass the blockage, which may help repair damage to the kidneys. Treatment might include antibiotics to clear associated infections. […] A ureteral obstruction that causes severe pain might require an immediate procedure to remove urine from your body and temporarily relieve the problems caused by a blockage. […] Your doctor can tell you which procedure or combination of procedures is best for you. Drainage procedures might provide temporary or permanent relief, depending on your condition. […] There are a number of surgical procedures used to correct ureteral obstructions. The type of procedure depends on your situation. […] Your doctor (urologist) determines the type of procedure and the best surgical approach to treat your condition.

• #5 Ureteral Obstruction | UMass Memorial Health

  https://www.ummhealth.org/services-treatments/urology/uteteral-obstruction

  A ureteral obstruction is a blockage in your ureters, the tubes that carry urine from your kidneys to your bladder. […] Fast, effective treatment from the urologists at UMass Memorial Health can help you find relief and prevent dangerous health complications. […] Talk to your primary health care provider or a urologist right away if you notice symptoms of a ureteral obstruction, such as: […] If you’ve been diagnosed with a ureteral obstruction or have concerning symptoms, our urologists are here to deliver a prompt diagnosis and treatment. […] Our first priority is to drain urine from your body to relieve symptoms and prevent permanent damage to your kidneys and urinary tract. […] Addressing the common causes of urethral obstruction can provide longer-term relief. […] Urologists at UMass Memorial Medical Center routinely diagnose and treat ureteral obstructions and strictures resulting from kidney transplantation, advanced cancer and gynecological or abdominal surgeries. […] Urologists, nephrologists (kidney specialists) and interventional radiologists at UMass Memorial work together to treat urinary tract disorders such as ureteral obstructions. […] Experts at UMass Memorial Medical Center frequently use endoscopic and robotic-assisted methods.

• #6 Urinary Obstruction and Ureteral Stricture: Causes and Treatment

  https://www.saintjohnscancer.org/urology/conditions/urinary-obstruction-urologic-reconstruction/

  Urinary obstruction can be the result of a variety of conditions. Our goal is to offer immediate and lasting relief, utilizing minimally invasive and best-practice techniques. […] A blockage that prevents the voiding of urine can cause a variety of problems, including pain and infections. […] Symptoms of Ureteral Stricture include side or back pain, feeling of fullness, blood in the urine, nausea, urinary tract infections, and pain worse with increased fluids or alcohol. […] Ureteroplasty is a procedure and surgery that can fix narrowing of the ureter tubes in the body that carry urine from the kidneys to the bladder. […] When scarring occurs in the ureter, urine does not drain well. This is often painful and can lead to infection and long-term kidney damage. […] After the cancerous area or organ has been removed, the robot is also used to repair areas of the body to restore function. […] Your doctor will share additional information and care instructions before and after surgery, which will be essential to maximize your recovery. […] Risks for patients after surgery could be urinary tract infections or kidney stones.

• #7 Ureteral Obstructions and Strictures | University of Utah Health

  https://healthcare.utah.edu/urology/conditions/ureteral-stricture-obstruction

  A ureteral obstruction is a blockage in your ureters. Your ureters are the tubes that carry urine from your kidneys to your bladder. Many conditions, including kidney stones, cancer, and ureteral strictures can cause an obstruction. […] Ureteral blockages and strictures are often treatable. But, without treatment, they can cause pain, kidney stones, urinary tract infections, kidney damage, and even kidney failure. […] Patients who do have symptoms of an obstruction may notice a few things: Frequent urinary tract infections (UTIs), High blood pressure (hypertension), Pain between your upper belly and back (flank pain), Pain in your kidneys, which feels like back pain. […] In severe cases, urine backup may cause your kidneys to swell. This is known as hydronephrosis. Blockages that dont get treated can damage your kidney function.

• #8 Update on the Management of Malignant Ureteral Obstruction – American Urological Association

  https://auanews.net/issues/articles/2023/may-2023/update-on-the-management-of-malignant-ureteral-obstruction

  Malignant ureteral obstruction (MUO) is a common condition for urologists to manage. […] Patients may present with renal colic, mild and nonspecific symptoms, or may be asymptomatic. […] In addition to pain, MUO may compromise renal function and lead to renal failure. […] Individualized prognosis and end of life or quality of life goals must be considered when deciding whether to intervene with ureteral decompression given that treatment-related side effects can lead to significant decreases in quality of life. […] In the absence of symptoms, observation alone is a very reasonable option for some patients pursuing a palliative approach that optimizes their quality of life. […] However, even in those with a noncurable diagnosis, ureteral decompression may relieve symptoms or preserve renal function, permitting palliative chemotherapy that may otherwise be contraindicated.

• #9 Obstructive uropathy: considerations for the nephrology nurse – PubMed

  https://pubmed.ncbi.nlm.nih.gov/15114798/

  Obstructive uropathy is the cause of renal failure in 16.2% of pediatric patients who undergo renal transplantation, 12.9% of those on dialysis, and 23.1% of those with chronic renal insufficiency, according to the annual report of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS). […] Successfully caring for patients with obstructive uropathy requires an understanding of the various congenital anomalies that create obstructive uropathy, the urological interventions used to treat them, management of the patient, and the nursing care required. […] Ureteral Obstruction / nursing Actions. […] Vesico-Ureteral Reflux / nursing Actions.

• #10 7 Urolithiasis (Renal Calculi) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/urolithiasis-nursing-care-plans/

  Deliver effective care to patients with urolithiasis with this nursing care plan and management guide. Gain insights into nursing assessment, interventions, goals, and diagnosis customized for their specific needs. Enhance your ability to provide specialized care for patients with renal calculi. […] Nursing goals for patients with urolithiasis aim to provide comprehensive care to manage pain, prevent complications, and facilitate the passage of kidney stones. […] The following are the nursing priorities for patients with urolithiasis: […] Managing acute pain is a top priority to provide immediate relief and improve the patients comfort. […] Prompt identification and treatment of any infection is crucial to prevent further complications and ensure the patients well-being. […] The primary goal of treatment is to eliminate kidney stones. […] Implementing preventive measures, such as lifestyle modifications, dietary changes, and appropriate medical therapies, is important to reduce the risk of future stone formation. […] Protecting renal function through early intervention and appropriate management strategies is essential to maintain the overall health of the patients urinary system. […] Informing patients about the causes, prevention strategies, signs of complications, and the importance of regular follow-ups to monitor their condition is important. […] Encouraging lifestyle changes, such as increased fluid intake, dietary adjustments (e.g., reduced sodium and oxalate intake), and regular physical activity, can help prevent stone recurrence and promote overall urinary health.

• #11 Complete – Nursing Care Plan – Group4 | PDF | Dehydration | Urinary Tract Infection

  https://www.scribd.com/document/486235627/COMPLETE-NURSING-CARE-PLAN-GROUP4

  The nursing care plan addresses the patient’s acute pain related to increased ureteral contractions from a kidney stone, as well as impaired urinary elimination related to renal obstruction. […] Independent nursing interventions include determining pain location/intensity, increasing fluid intake, applying warm compresses, and administering pain medication as ordered. […] Collaborative interventions include treating underlying conditions and identifying changes requiring medical follow-up. […] The desired outcomes within 8 hours are for the patient to report relieved pain and normal urine output without obstruction signs.

• #12 Kidney Stones: Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether

  https://www.nursetogether.com/kidney-stones-nursing-diagnosis-care-plan/

  Treatment and management of kidney stones will depend on the type and size of the stone. Nursing care and interventions for patients with kidney stones include pain relief, preventing complications, and maintaining adequate renal function. Health teaching is essential in preventing the recurrence of kidney stones. The patient will need education regarding potential treatments, diet modifications, 24-hour urine testing, and surgical recovery. […] Nursing interventions and care are essential for the patients recovery. In the following section, you will learn more about possible nursing interventions for a patient with kidney stones. […] Nursing Diagnosis: Acute Pain […] Nursing Diagnosis: Deficient Knowledge […] Nursing Diagnosis: Imbalanced Nutrition: Less Than Body Requirements […] Nursing Diagnosis: Impaired Urinary Elimination […] Nursing Diagnosis: Ineffective Tissue Perfusion

• #13 Nursing Care Plans for Renal Calculi/Kidney stone ~ Lifenurses

  http://www.lifenurses.com/2010/03/nursing-care-plans-for-renal.html

  Intractable pain and serious bleeding also can result from calculi and the damage they cause. […] Nursing Diagnosis nursing care plans for Renal Calculi/Kidney stones determine by what we found in nursing assessment. […] Common nursing diagnosis found in Nursing Care Plans for Renal Calculi/Kidney stones Acute pain Altered urinary elimination Deficient knowledge (treatment plan) Impaired urinary elimination Ineffective tissue perfusion: Renal Risk for imbalanced fluid volume Risk for infection Risk for injury. […] Administer prescribed analgesic. […] Encourage patient to assume position that brings some relief. […] Reassess pain frequently using pain scale. […] Assess degree of interference/disability. […] Determine clients previous pattern of elimination and compare with current situation. […] Investigate pain which may be indicative of infection. […] Achieve normal elimination pattern or participate in measures to correct/compensate for defects. […] Demonstrate behaviors/techniques to prevent urinary infection.

• #14 7 Urolithiasis (Renal Calculi) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/urolithiasis-nursing-care-plans/

  Acute pain is common in patients with urolithiasis because the passage of kidney stones through the urinary tract can cause irritation, inflammation, and obstruction, leading to intense pain. The severity of the pain can vary depending on the size and location of the stone. Effective pain management in patients with urolithiasis serves several important purposes. First and foremost, it aims to provide relief and alleviate suffering. The excruciating pain associated with kidney stones can significantly impact the patients physical and emotional well-being, impairing their daily activities and overall quality of life. By effectively managing pain, healthcare professionals can alleviate distress and improve the patients comfort. […] Because the presence of kidney stones in the urinary tract can cause blockages or partial obstructions, impaired urinary elimination is a common problem in patients with urolithiasis. This can result in urinary retention, urinary tract infections, and other complications. Effective urinary elimination aims to ensure the proper passage of urine, aid in the elimination of kidney stones, and maintain the overall health of the urinary system. The goals of promoting effective urinary elimination in patients with urolithiasis are multifaceted. First and foremost, it aims to relieve urinary obstruction and restore the normal flow of urine. By facilitating the passage of urine, healthcare professionals can help alleviate pain, reduce urinary stasis, and prevent further complications, such as urinary tract infections or renal damage.

• #15 7 Urolithiasis (Renal Calculi) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/urolithiasis-nursing-care-plans/

  Patients with urolithiasis are at risk for inadequate fluid volume due to factors such as dehydration, reduced oral intake, and increased urinary output resulting from the formation and passage of kidney stones. Additionally, after the obstruction caused by a kidney stone is relieved, some patients may experience post-obstructive diuresis, which can further increase urinary output and exacerbate fluid and electrolyte imbalances. Achieving and maintaining appropriate fluid balance is essential in preventing stone recurrence, promoting stone passage, and preserving urinary system health. Effective management of fluid balance aims to ensure adequate hydration, promote urinary flow, and prevent the recurrence of kidney stones. […] Providing patient education and teachings for lifestyle changes is a crucial component of care for patients with urolithiasis, a condition characterized by the formation of kidney stones in the urinary tract. Urolithiasis is influenced by various lifestyle factors, including diet, fluid intake, and physical activity. Educating patients about these factors and empowering them to make necessary lifestyle modifications is essential in preventing stone recurrence, promoting overall urinary health, and improving long-term outcomes.

• #16 18 | How to successfully care for cats with ureteral obstructions — Veterinary Internal Medicine Nursing

  https://www.veterinaryinternalmedicinenursing.com/blog/episode-18

  Ureteral obstructions are being diagnosed more and more often now than ever, particularly in cats – and there is a LOT we can do as nurses and technicians to support these patients. […] They usually present markedly painful and with post-renal AKI, which can be life-threatening if bilateral obstructions are present and often require intensive treatment and nursing care. […] Urgent treatment is indicated to restore as much renal function as possible. Most of these patients will require referral for treatment since advanced surgical management is needed, alongside intensive monitoring and management of the patients AKI. […] Postoperatively, these patients require analgesia and supportive care alongside the management of their acute kidney injury. This includes monitoring urine output and matching this with intravenous fluid therapy (post-obstructive diuresis is expected after SUB placement, meaning these patients will lose larger amounts of fluid and electrolytes after the obstruction is relieved).

• #17 Ureteral obstruction – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ureteral-obstruction/diagnosis-treatment/drc-20354680

  Our caring team of Mayo Clinic experts can help you with your ureteral obstruction-related health concerns […] The goal of ureteral obstruction treatment is to remove blockages, if possible, or bypass the blockage, which may help repair damage to the kidneys. Treatment might include antibiotics to clear associated infections. […] A ureteral obstruction that causes severe pain might require an immediate procedure to remove urine from your body and temporarily relieve the problems caused by a blockage. Your doctor (urologist) may recommend: […] Your doctor can tell you which procedure or combination of procedures is best for you. Drainage procedures might provide temporary or permanent relief, depending on your condition. […] There are a number of surgical procedures used to correct ureteral obstructions. The type of procedure depends on your situation. […] Your doctor (urologist) determines the type of procedure and the best surgical approach to treat your condition.

• #18 Ureteral Obstruction: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21155-ureteral-obstruction

  A ureteral obstruction prevents pee from moving into your bladder and out of your body. Without treating and removing the blockage, pee can back up and damage your kidneys. This can cause pain and put you at risk of infection. In severe cases, a ureteral obstruction can lead to kidney failure, sepsis (life-threatening infection) or death. This is rare, though, because healthcare providers can treat ureteral blockages. […] The treatment you receive depends on the reason for the blockage. First, your healthcare provider will perform a procedure to allow the pee to drain from your body. These procedures include: […] After draining the pee, your provider will address the reason for the blockage. What happens next will depend on what caused the obstruction and the severity of the blockage. […] If you have signs of ureteral obstruction, you should call your healthcare provider right away. Symptoms may be mild at first but can get worse quickly and be very serious.

• #19

  https://www.aurorahealthcare.org/services/urology/ureteral-obstruction

  Your surgery may be traditional or laparoscopic. Laparoscopies are minimally invasive surgeries that decrease pain, bleeding, complications and recovery time. […] Aurora specializes in: Laparoscopic pyeloplasty: Your surgeon makes small incisions in your abdomen and uses precise instruments, including a tiny camera called an endoscope, to remove obstructions from your urinary tract. Robotic pyeloplasty: This is similar to a laparoscopic pyeloplasty, but your surgeon uses robotic instruments in the procedure.

• #20 Renal Obstruction & Ureteral Strictures – Kidney Stones & Urinary Obstruction | UCLA Health

  https://www.uclahealth.org/medical-services/urology/kidney-stone/renal-obstruction-ureteral-strictures

  Ureteropelvic junction (UPJ) obstruction is when there is a blockage where the kidney attaches to the ureter (the tube that carries urine to the bladder). The blockage slows or stops the flow of urine out of the kidney, which can cause pain, infection, and kidney failure. The physicians in UCLA Urologys Division of Endourology are experts in prompt diagnosis and treatment of UPJ obstruction. […] A narrowing or stricture of the ureter can stop the flow of urine and cause pain, infection, and kidney failure. Our experts specialize in advanced endoscopic and minimally invasive techniques to reestablish drainage from the kidney and preserve kidney function. […] Our experts utilize state-of-the-art surgical techniques to address UPJ obstruction or ureteral strictures: […] A narrow silicone tube called a stent may be placed after these procedures to allow the area to heal properly while draining the kidney. The stent is removed a few weeks later in the office. […] Detecting and treating the problem promptly can help prevent loss of kidney function. Most people recover well from surgery and have no long-term problems. A small percentage of patients may still develop kidney stones or infections in the affected kidney.

• #21 Ureteral Obstructions and Strictures | University of Utah Health

  https://healthcare.utah.edu/urology/conditions/ureteral-stricture-obstruction

  Treatment for a ureteral obstruction varies based on the underlying cause. Sometimes treatment starts with procedures to help urine drain from your body: Nephrostomy tube: We make an opening in the skin near your kidney and insert a tube that allows urine to drain. Our interventional radiologists perform this procedure. Ureteral stenting: Your surgeon places a hollow tube inside your ureter to open it. This may be temporary treatment before surgery. […] Your urologist may be able to treat the underlying cause of the blockage after addressing the urine drainage. They may use one or several treatments: Balloon dilation, a procedure that uses a catheter (drainage tube) and balloon to widen a ureteral stricture, Surgery to remove the blockage and repair your ureter. […] University of Utah Health urologists are experts at treating ureteral obstructions and strictures. We combine clinical expertise with the latest research findings and state-of-the-art equipment. Our surgical specialists provide patients with the highest level of care available in the Mountain West.

• #22 Update on the Management of Malignant Ureteral Obstruction – American Urological Association

  https://auanews.net/issues/articles/2023/may-2023/update-on-the-management-of-malignant-ureteral-obstruction

  Placement of a percutaneous nephrostomy (PCN) is traditionally the next step when stenting is not successful, not tolerated, or in stent failure. […] Advantages of PCN include maximized drainage, ability to be placed under local anesthesia, and easier monitoring of urine output and tube function. […] Disadvantages include ongoing need for 3-month exchanges and risk of infection, renal complications, and tube dislodgment, and patients actively anticoagulated may not be candidates. […] A recent study showed that there were similar negative quality of life effects with both TUS and PCN placement, although patients who had been treated with both preferred TUS over PCN. […] In conclusion, MUO can be managed with DJS, tandem ureteral stents, reinforced stents, metallic stents, PCN tubes, or extra-anatomical urinary diversion. […] All have potential downsides, so quality of life effects of each option, frequency of exchanges, and cost of exchange procedures should be taken into consideration.

• #23 :: ICU :: Investigative and Clinical Urology

  https://icurology.org/DOIx.php?id=10.4111/kju.2012.53.9.625

  We assessed the efficacy and safety of insertion of a polytetrafluoroethylene membrane-covered self-expandable metallic stent (UVENTA stent) for palliation of malignant ureteral obstruction on the basis of our early results. […] UVENTA stents may relieve malignant ureteral obstruction safely and easily. Long-term follow-up is necessary to assess the role of this stent in the treatment of malignant ureteral obstruction. […] The limitations associated with conventional treatments for ureteral obstructions highlight the need for a novel treatment that can maintain ureteral patency while minimizing the deterioration of patient quality of life. […] The recently developed UVENTA stent prevents tumor ingrowth through the mesh and is resistant to stent-related complications. Therefore, it obviates the need for regular stent changes and thus offers significant benefits for patients with limited life expectancy. […] PTFE membrane-covered self-expandable metallic stents can relieve malignant ureteral obstructions safely and easily. Long-term follow-up is required to assess the role of these stents in the treatment of malignant ureteral obstructions.

• #24 Subcutaneous Ureteral Bypass (SUB) in Cats

  https://todaysveterinarynurse.com/urology-renal-medicine/subcutaneous-ureteral-bypass-as-a-treatment-option-for-urolithiasis-in-cats/

  Traditional surgical options to relieve ureteral obstruction in cats are invasive, and perioperative and postoperative complications such as uroabdomen and persistent obstruction due to ureteral inflammation, edema, spasm, stenosis, and stricture are common. […] Therefore, the best option for treatment, currently recommended by a consensus statement from the American College of Veterinary Internal Medicine, is ureteral stenting or subcutaneous ureteral bypass. […] The SUB 1.0 was designed as a salvage procedure when a stent could not be placed, but it quickly gained an advantage over stents due to fewer complications and better tolerance in cats. […] Placement of the SUB 3.0 requires fluoroscopic and surgical assistance. […] A team of specialists in surgery and interventional procedures, along with trained veterinary nurses, is needed to optimize patient outcomes.

• #25 18 | How to successfully care for cats with ureteral obstructions — Veterinary Internal Medicine Nursing

  https://www.veterinaryinternalmedicinenursing.com/blog/episode-18

  After the patient is discharged, our care does not end. These patients require regular reassessments to evaluate their renal function and maintain the SUB device. SUBs are not without complications, and things like obstruction, mineralisation, infection and displacement or fracture of the device are all reported – so we need to regularly check the patency of the device and collect urine samples from it to check for infection.

• #26 VNJ March 2022 – Bilateral ureteral obstruction and subcutaneous ureteral bypasses: A feline case report – Part 2 – British Veterinary Nursing AssociationBritish Veterinary Nursing Association

  https://bvna.org.uk/blog/vnj-march-2022-bilateral-ureteral-obstruction-and-subcutaneous-ureteral-bypasses-a-feline-case-report-part-2/

  Bilateral ureteral obstruction in felines is relatively uncommon, with subsequent placement of bilateral subcutaneous ureteral bypasses even more uncommon for veterinary nurses to encounter in practice. […] Ongoing monitoring of renal values and maintenance of the SUBs is critical to the patients long-term survival and quality of life. […] Maintenance of the SUBs is achieved via a flushing procedure of the SUB device. […] A feeding-kit box was given to the owner with all the necessary consumables to complete these tasks. […] Overall, holistic involvement of multiple disciplines, nursing care, owner compliance and patient compatibility is key to a successful outcome.

• #27

  https://journals.lww.com/cur/fulltext/2024/03000/the_challenging_management_of_malignant_ureteral.8.aspx

  The most frequently identified complications after double-J or PCN placement were urinary tract infection (24.4%), followed by urinary sepsis (14.9%). […] Urologists and oncologists commonly face difficulties regarding the management of hydronephrosis in patients with advanced cancer. Because cancer patients with MUO have poor prognosis, therefore, complications and potential worsening of QoL in these patients should be carefully considered. Furthermore, cachexia and hydronephrosis grades can be useful in selecting suitable candidates for urinary decompression.

• #28

  https://link.springer.com/article/10.1007/s00520-020-05662-z

  We aimed to evaluate the long-term complications and predisposing factors for these complications in patients with malignant ureteral obstruction (MUO) treated with percutaneous nephrostomy (PN). […] The records of patients with MUO treated with PN between January 2015 and 2018 were retrospectively reviewed for PN dislodgement, PN obstruction, PN replacement, pyelonephritis, hospitalizations due to PN complications, and other complications due to PN such as macroscopic hematuria, skin infections, or renal/perirenal abscess. […] The most common complication in patients with MUO treated with PN was PN dislodgement. However, life-threatening complications such as macroscopic hematuria and severe infections can also occur. Patients with DM, LEL, and chemotherapy are at high risk of PN-related complications.

• #29 7 Urolithiasis (Renal Calculi) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/urolithiasis-nursing-care-plans/

  Medications play a vital role in the management of urolithiasis by addressing various aspects of the condition, including pain control, prevention of stone formation, and treatment of associated complications. The administration of medications and pharmacologic support in patients with urolithiasis requires close collaboration between healthcare professionals and patients. […] Urolithiasis can give rise to various complications that require vigilant assessment and ongoing monitoring to ensure timely intervention and optimal patient outcomes. Urolithiasis, the presence of kidney stones in the urinary tract, can lead to a range of complications that can significantly impact patient health and well-being. Proactive assessment and ongoing monitoring of patients with urolithiasis are essential to identify potential complications, initiate timely interventions, and prevent further adverse outcomes.

• #30 7 Urolithiasis (Renal Calculi) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/urolithiasis-nursing-care-plans/

  Laboratory and diagnostic tests provide valuable information about the patients kidney function, stone composition, and overall health status, aiding in accurate diagnosis, treatment planning, and monitoring of potential complications. Monitoring laboratory and diagnostic procedures allows healthcare professionals to identify complications, determine stone characteristics, and guide appropriate treatment strategies. By closely monitoring these parameters, healthcare professionals can promptly identify any changes, tailor interventions, and ensure effective management of urolithiasis, ultimately improving the patients quality of life.

• #31 8.11 Urolithiasis – Health Alterations

  https://wtcs.pressbooks.pub/healthalts/chapter/8-11-urolithiasis/

  Nursing diagnoses for clients with urolithiasis can help guide nursing care and address the specific needs of these individuals. […] Nursing interventions for urolithiasis aim to alleviate symptoms, facilitate stone passage, prevent complications, and provide support and education to clients. […] Nurses encourage adequate hydration by drinking adequate amounts of fluids to help dilute urine and prevent the concentration of minerals that can form stones. […] Nurses teach about prescribed analgesics and nonpharmacological interventions to manage severe pain. Nonpharmacological interventions include application of heat, repositioning, and ambulation to help facilitate the passage of the stone. […] During the evaluation stage, nurses determine the effectiveness of nursing interventions for a specific client.

• #32 Subcutaneous Ureteral Bypass (SUB) in Cats

  https://todaysveterinarynurse.com/urology-renal-medicine/subcutaneous-ureteral-bypass-as-a-treatment-option-for-urolithiasis-in-cats/

  Knowledge, training, and experience with troubleshooting help ensure the system will last the patient’s lifetime. […] Maintenance of the SUB system involves accessing the shunting port for a urine sample, flushing the system with sterile saline to ensure patency of both the nephrostomy and cystostomy tubes, and infusing a solution of tetrasodium ethylenediaminetetraacetic acid (EDTA) as a locking solution. […] The SUB 3.0 is designed to prevent overinsertion of the cystostomy catheter within the bladder lumen and allows cats with bilateral obstruction to have a single cystostomy tube. […] Surgical complications may directly correlate with experience at the institution placing the SUB. […] A record should be kept of each SUB flush or access, including any measurements, the ability to withdraw and infuse, and any characteristics related to the bubble study. […] Good communication with the client before implantation of a SUB system allows the veterinary team to better manage expectations.

• #33 bilateral ureteral obstruction Archives – British Veterinary Nursing AssociationBritish Veterinary Nursing Association

  https://bvna.org.uk/blog/tag/bilateral-ureteral-obstruction/

  Bilateral ureteral obstruction in felines is relatively uncommon, with subsequent placement of bilateral subcutaneous ureteral bypasses even more uncommon for veterinary nurses to encounter in practice. […] Ongoing monitoring of renal values and maintenance of the SUBs is critical to the patients long-term survival and quality of life. […] Maintenance of the SUBs is achieved via a flushing procedure of the SUB device. […] A feeding-kit box was given to the owner with all the necessary consumables to complete these tasks. […] The commitment of the owner and temperament of the patient bodes well with the ongoing requirements following SUB placement. Overall, holistic involvement of multiple disciplines, nursing care, owner compliance and patient compatibility is key to a successful outcome.

• #34 Palliative care underutilized in malignant ureteral obstruction

  https://www.urologytimes.com/view/palliative-care-underutilized-in-malignant-ureteral-obstruction

  Overall, 39.1% of patients with malignant ureteral obstruction were referred to palliative care over the study period. […] Less than half of patients with malignant ureteral obstruction, a serious complication of advanced cancer, received palliative care for their condition, according to findings published in Urology Practice. […] According to the authors, Concurrent dedicated palliative care services and oncologic treatment is recommended for patients with advanced cancer. […] Earlier referral to palliative care might help to promote informed decisions about preferences for care among patients with malignant ureteral obstruction. […] Overall, 39.1% (45 of 115) of patients utilized palliative care over the study period and spent a median of 12.5 days (IQR, 352 days) on non-hospice palliative care.

• #35 Palliative care is underused for patients with malignant urinary obstruction | Wolters Kluwer

  https://www.wolterskluwer.com/en/news/palliative-care-is-underused-for-patients-with-malignant-urinary-obstruction

  Less than half of patients with malignant ureteral obstruction (MUO) a serious complication of advanced cancer, with a poor prognosis receive palliative care (PC) for their condition, reports a paper in the January issue of Urology Practice. Hospice care can promote patient comfort while avoiding aggressive and invasive treatments for MUO patients nearing the end of life, according to the new research led by Michael D. Felice, MD, of Loyola University Medical Center, Maywood, Ill. „Earlier referral to palliative care might help to promote informed decisions about preferences for care among patients with MUO,” Dr. Felice comments. […] „Concurrent dedicated palliative care services and oncologic treatment is recommended for patients with advanced cancer,” Dr. Felice and colleagues write. However, the use of palliative care by patients with MUO remains unclear.

• #36 Palliative care is underused for patients with malignant urinary obstruction | Wolters Kluwer

  https://www.wolterskluwer.com/en/news/palliative-care-is-underused-for-patients-with-malignant-urinary-obstruction

  Patients with MUO „are ideal candidates for palliative care consultation to help navigate the complexities of multidisciplinary care and guide decision-making,” Dr. Felice and coauthors write. „Ideally, patients would be referred to PC after MUO diagnosis and prior to the decision regarding urinary decompression.” […] The researchers conclude: „Urologists may be particularly poised to promote interdisciplinary collaboration and initiate conversations regarding incorporating palliative care due to our multifaceted involvement in caring for patients with MUO.”

• #37 Palliative care underutilized in malignant ureteral obstruction

  https://www.urologytimes.com/view/palliative-care-underutilized-in-malignant-ureteral-obstruction

  There was an average 61-day delay between diagnosis with malignant ureteral obstruction and evaluation for palliative care. […] Only 11.1% (5 of 45) patients who received palliative care were referred before decisions regarding decompression treatment were made. […] The authors conclude, „Urologists may be particularly poised to promote interdisciplinary collaboration and initiate conversations regarding incorporating palliative care due to our multifaceted involvement in caring for patients with malignant ureteral obstruction.”

• #38 Subcutaneous Ureteral Bypass (SUB) in Cats

  https://todaysveterinarynurse.com/urology-renal-medicine/subcutaneous-ureteral-bypass-as-a-treatment-option-for-urolithiasis-in-cats/

  The subcutaneous ureteral bypass (SUB) system has revolutionized the treatment of upper urinary tract urolithiasis in cats over the past 10 years. […] Knowledge of the disease process of feline upper urinary tract urolithiasis and current treatment recommendations is important for veterinary nurses. Effective client education involves understanding available treatment options, indications for intervention, and associated risks and complications. […] In patients that receive a SUB, long-term management of the device after placement is also required; therefore, understanding the various components is essential for a successful outcome. […] Medical management may be attempted if the patient is stable with minimal compromise of renal function and no, or only mild, hydroureter or hydronephrosis are seen.

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