Success rate of Double J stent insertion in patients with advanced cervical cancer and hydronephrosis at tertiary hospital.

INTRODUCTION

Obstructive uropathy is a common complication in advanced cervical cancer, occurring because of ureteral compression by the tumour mass and often leading to hydronephrosis and impaired renal function. Double-J (DJ) stent insertion is frequently used as the first-line decompression method to restore ureteral patency; however, its technical success is influenced by anatomical distortion and severity of obstruction. Understanding the factors associated with successful stent placement is essential to guide appropriate urinary diversion strategies.

MATERIALS AND

METHODS

This retrospective cross-sectional study included 275 patients with confirmed advanced cervical cancer and hydronephrosis treated at Dr. Saiful Anwar General Hospital, Malang, from January 2019 to July 2025. Data collected included age, cervical cancer stage, hydronephrosis grade, DJ stent insertion status, histopathology findings, and survival status. Statistical analysis using the Kruskal-Wallis test and Spearman correlation assessed the association between clinical variables and DJ stent insertion.

RESULTS

DJ stent insertion was successfully performed in 56.7% of patients. Hydronephrosis grade (p = 0.027) and cervical cancer stage (p = 0.046) were significantly associated with successful stent insertion in univariate analysis, whereas histopathological subtype was not (p = 0.970). Patients with higher-grade hydronephrosis had significantly lower odds of successful stent insertion. Correlation analysis showed no significant monotonic relationship between hydronephrosis severity and cancer stage (ρ = -0.041, p = 0.503). In multivariate logistic regression analysis, severe hydronephrosis emerged as an independent predictor of DJ stent insertion failure (OR 0.30, 95% CI 0.11-0.83, p = 0.021), while cervical cancer stage and histopathological subtype were not significant after adjustment.

CONCLUSION

Hydronephrosis severity and cervical cancer stage influence the success of DJ stent insertion in advanced cervical cancer; however, hydronephrosis severity appears to be a more direct determinant of stenting feasibility than cancer stage alone, whereas histopathological subtype shows no significant association.