Non-interventional management of obstructive acute renal-failure in hormone-naïve prostate cancer.

Advanced carcinoma prostate (CaP) commonly presents as bilateral ureteric obstruction. The management often requires androgen ablation along with temporary urinary diversion (percutaneous nephrostomy or ureteric catheterization) which is not infrequently associated with complications. Two patients of hormone-naïve CaP presented to our emergency department with oliguric renal failure due to bilateral ureteric obstruction and were treated with dialysis, ketoconazole (for androgen ablation) and corticosteroids; urinary diversion was not feasible in either at the time of presentation. Brisk diuresis occurred within 48 hours obviating the need of urinary diversion. Follow-up of these cases is presented and justification of this approach is discussed.