Obstructive Neoplastic Anuria Overview at Ibn Rochd University Hospital–A Retrospective Study

Introduction : Obstructive anuria due to pelvic cancers is the most common obstructive anuria in our context, its diagnosis is easy, but it causes a lot of morbidity with often heavy and long management.                                     

Materials and methods : This is a retrospective study containing 40 cases of confirmed neoplastic anuria treated in the urology department at the Ibn Rochd University Hospital in Casablanca Morocco between January 2016 and October 2018.

Purpose : The aim of our study was to establish the epidemiological, clinical, therapeutic and natural historyin patients with neoplastic obstructive anuria.

Results : The mean age was 56 years old with a notable female predominance. The male to female ratio was 0.6. Sixty percent (60%) of our patients were consulted within24 hours after the onset of anuria, the main symptoms preceding or accompanying anuria were lower back pain (75%) and hematuria (37.5%).

Criteria for a positive diagnosis included urinary retention with complete absence of diuresis, the anuria was confirmed by probing or ultrasound, dilation of the urinary excretory system on ultrasound and acute impairment of renal function.

To prevent patient from going into metabolic disorders, hemodialysis was performed in 27 patients (67.5%). Internal diversion of urine by mounting a JJ catheter was initially attempted in 40% of the cases. In case of attempt failure, or in case of locally advanced pelvic tumors, percutaneous nephrostomy was performed with a success rate of 100%.

Upon follow up for 30 months, mortality rate was 5% (n=2), 95% of the patients benefited from a specialized follow-up for their etiological neoplasm.

 Conclusion : The management of neoplastic obstructive anuria must be rapid, the type of urinary diversion is chosen according to the clinical presentation and the technical platform available.