prOsPecTIve MultIcentre Study investigating the managemEnt of patients with Malignant Ureteric Obstruction (OPTIMISE MUO)
Project Summary
Urologists and Interventional Radiologists are frequently referred cancer patients with hydronephrosis secondary to malignant ureteric obstruction (MUO). This causes renal failure, severe pain, urosepsis, and may prevent cancer treatment or threaten life. Percutaneous nephrostomy (PCN) insertion, and ureteric stenting (US) can relieve obstruction. Both require regular tube exchanges in hospital, usually for the patient's remaining lifetime.
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Unlike other oncology emergencies such as metastatic spinal cord compression, no standardised care pathway exists for MUO and there is geographical variation in management approach. In addition, little is known about the patients that do not receive intervention. No data exists to explain why differing management decisions are made in patients with MUO.
OPTIMISE MUO seeks to answer these questions.
Project Status
Recruitment for OPTIMISE MUO is ongoing.
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The OPTIMISE MUO methodology relies on a close working relationship between the study team and the local radiology and urology clinical teams (i.e case capture will be most effective if on call, and MDT radiologists and on call urology teams know to flag MUO cases to the local OPTIMISE MUO study teams). It is for this reason that Consultant Radiologist and/or Urologist inclusion is mandatory in the local study team.
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The study will run for a 1 month period (Late 2024/Early 2025, tbc). Subsequent participant follow up will be at 3 monthly intervals for 12 months.
Any publications resulting from the OPTIMISE MUO project will be as a collaborative. All collaborators will be accredited as collaborators on any publications from the study and will be Pubmed citable.
If you are interested in getting involved, please enter your details here: https://forms.gle/McsHQLyda8KmusZg7 or email MUOstudies@gmail.com for more information.
The details
Study design
Prospective multi-centre research study
Inclusion Criteria
Patients aged 18 or over
New diagnosis of malignant ureteric obstruction as part of standard clinical care
Undergoing:
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Percutaneous nephrostomy insertion
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Ureteric stent insertion
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No intervention
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Other, rare forms of intervention such as extra-anatomical stent insertion or urinary diversion.
Exclusion criteria
Patients under 18. Benign cause MUO. Patients who have had previous intervention for MUO
Sample size
180 cases
Follow-up Duration
Patients under 18. Benign cause MUO
1 year
Planned Study Period
Not calculated
Expected February 2025
Primary objective
Determine the reasons for management choices made by clinical teams in malignant ureteric obstruction and determine their efficacy to achieve the intended outcomes.
How to contact us
https://forms.gle/McsHQLyda8KmusZg7 or email MUOstudies@gmail.com for more information.
Team and funding
Principal Investigators
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Dr Oliver Llewellyn MRCS FRCR is an Interventional Radiology ST5 in Glasgow and RCR Kodak Research Fellow
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Mr James Blackmur PhD FRCSEd(Urol) is a post-CCT Senior Clinical Fellow in Urology at Addenbrooke’s Hospital, Cambridge.
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Mr Alexander Laird PhD FRCSEd(Urol) is a Consultant Urologist and Honorary Clinical Lecturer at The University of Edinburgh.
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Specialist Advisors
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Mr Jonathan Aning FRCS(Urol) DM BM BS BMedSci is a Consultant Urologist at Bristol Urological Institute and Honorary Associate Professor at Bristol University
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Dr Tristan Barrett FRCR MD is an Associate Professor of Radiology and Consultant Radiologist at Addenbrookes Hospital, Cambridge.
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Dr Nadeem Shaida FRCR is a Consultant Interventional Radiologist at Addenbrookes Hospital, Cambridge and sits on the British Society of Interventional Radiology research committee panel.
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Ethics & Funding
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This study is sponsored by ACCORD (NHS Lothian & University of Edinburgh)
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This study is funded by the Royal College of Radiologists.
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This study has received research ethics committee opinion (Ref 23/NRS/0070)
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This study has received HRA approval in England & Wales (Protocol no AC23185)​
