Initial experience for treatment of refractory ureterovaginal fistula using self-expandable metal stent (Allium TM stent): a report of four cases and review of literatures

Abstract

Objective To report our initial experience in the treatment of refractory ureterovaginal fistula (UVF) with Allium™ stent, and to review related literatures. Methods From May 2019 to June 2021, four patients with refractory UVF were treatment with Allium™ stent in our department. Refractory UVF was defined as failure of previous treatment and the patient was not suitable for open or laparoscopic surgery. The process was described as follows, the affected ureter was dilated with balloon followed by placement of Allium™ stent, the stent was finally removed and stent-free was achieved. The perioperative and follow-up data were reviewed. Results UVF of these four patients was developed after gynecological surgery. All patients had received previous treatment, including ureteral reimplantation in one patient and endoscopic treatment in three patients. The mean age of patients was 47 (35–54) years. The mean time from fistula diagnosis to Allium™ stent placement was 8 (4–16) months. The mean operative time was 36 (25–50) minutes. All of four patients was confirmed of ureteral stricture intraoperatively. Leakage of urine was disappeared within two days in all patients. No high grade (MCCS Ⅲ or Ⅳ) complications was occurred postoperatively. The mean indwelling time of Allium™ stent was 17 (12–23) months and the mean stent-free follow-up removal was 9 (1–22) months. No patients developed recurrence of leakage or ureteral stricture. Conclusions Our initial results and experience showed that it is safe and feasible to treat refractory UVF with Allium™ stent. The long-term follow-up results still need to be verified.