Author(s): Wakui M, Takeuchi S, Isioka J, Iwabuchi K, Morimoto S
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Abstract OBJECTIVE: To report our experience of using metallic stents to treat ureteric obstruction caused by malignant or benign disease. PATIENTS AND METHODS: Nine patients with obstruction in 11 ureters caused by malignant or benign disease (mean age 61 years, range 35-82, mean follow-up 7 months, range 3-11) were treated using metallic stents. A balloon-expandable metallic stent was used in one patient and self-expandable metallic stents in the remaining eight. All stents were inserted via a percutaneous antegrade approach. RESULTS: Of the 11 ureters, nine remained patent with no further manipulation during the follow-up of 3-11 months. An additional stent was placed in continuity with the first in two ureters of two patients at 4 and 5 weeks after the first procedure because of persistent obstruction. After the second intervention, their obstruction was improved. Transient vesico-ureteric reflux occurred in two of three stented distal ureters, but the reflux resolved spontaneously within 2 months after stent implantation. Ureteric patency was maintained in all patients and no major complications related to stenting occurred during the follow-up. Two patients died from cervical cancer at 3 and 5 months after stenting. CONCLUSION: In patients with difficult ureteric obstructions a metallic stent provides a safe and effective alternative to an indwelling double-pigtail catheter or percutaneous nephrostomy.
This article was published in BJU Int
and referenced in Medical & Surgical Urology