Re: Outcome of retrograde ureteric stenting as a urinary drainage procedure in ureteric obstruction related to malignant lesions.

We read with interest the article by Wijayarathna et al. offering retrograde ureteric stenting (RUS) as the urinary drainage of first choice to all patients with recurrent malignancies in the pelvic cavity causing malignant ureteric obstruction (MUO) [1]. The authors knew that most of these patients had exhausted the primary modalities of treatment of their respective malignancies and regrettably, they still performed ‘palliative’ urinary diversion routinely. This paper fails to state the number of patients with bilateral ureteric obstruction, percentage of them with uraemia, and ureteric units successfully stented. In MUO, ‘palliative’ urinary diversion, percutaneous nephrostomy (PCN) or RUS, should be performed only if there is a definitive treatment plan available for the patient as the quality of life can be suboptimal and the patient’s ability to return home for at least 2 months prior to death is often compromised by such unnecessary intervention.