Nephrostomies in obstructive uropathy; how should hormone resistant prostate cancer patients be managed and can we predict who will benefit?

Current opinion advocates the use of nephrostomies in hormone naive patients with obstructive uropathy while hormone resistant patients require an individual approach. Patients undergoing a nephrostomy for uropathy were retrospectively analysed, with particular interest in hormone status and blood levels. Over a 46-month period, 26/112 nephrostomies were performed for prostate cancer induced uropathy. Survival was 226.5 days for hormone naive patients, 114.3 days in the responsive group and 100.2 days if resistant. Bilateral cases survived 72.1 days versus 157.6 days for unilateral patients. All patients should be considered for nephrostomy despite their hormone status.