Initial experiment of self-expanding metal ureteral stent in recurrent ureteral stenosis after kidney transplantation

Song, Ting; Zeng, Jun; Lin, Tao; Fan, Yu; Wei, Xin

doi:10.1111/ajt.16444

Cited by 6 publications

(4 citation statements)

References 4 publications

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“…The stent is made of super elastic nickel-titanium alloy, which maintain lumen patency via providing long-term direct wall support. The stent patency rate was 84% during a median observation time of 16 months in our study, which is slightly lower compared with previous study [ 15 ]. Zhong et al reported a success rate of 87.5% with the use of Allium ureteral stent in the treatment of ureteral stricture after kidney transplantation [ 15 ].…”

Section: Discussioncontrasting

confidence: 83%

“…The stent patency rate was 84% during a median observation time of 16 months in our study, which is slightly lower compared with previous study [ 15 ]. Zhong et al reported a success rate of 87.5% with the use of Allium ureteral stent in the treatment of ureteral stricture after kidney transplantation [ 15 ]. However, the mean length of ureteral stricture was 2.5 cm in their series.…”

Section: Discussioncontrasting

confidence: 83%

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Metal stent for the ureteral stricture after surgery and/or radiation treatment for malignancy

et al. 2021

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Background To assess the efficacy and safety of self-expanding metal ureteral stent for the stricture following surgery and/or radiation for malignancy. Methods We performed 36 metal ureteral stent insertion procedures (32 patients) between May 2019 and June 2020. The main inclusion criterion was the patients with ureteral stricture due to surgery and/or radiation treatment for malignancy. The diagnosis of stricture was ascertained by history and radiographic imaging. The etiologies underlying the strictures were: surgery and/or radiation therapy for cervical and rectal cancer, surgery for ovarian cancer. The primary outcome was the stent patency rate, and the secondary outcomes were the postoperative complications and glomerular filtration rate (GFR). Stent patency was defined as stent in situ without evident migration, unanticipated stent exchange or recurrent ureteral obstruction. Cost analysis was calculated from stent cost, anesthesia cost and operating room fee. Results The pre-metallic stent GFR was 22.53 ± 6.55 mL/min/1.73 m2. Eight patients were on double-J stents before insertion of metallic stents. The total annual cost of per patient in our study was $10,600.2 US dollars (range $9394.4–$33,527.4 US dollars). During a median follow-up time of 16 months (range 8–21 months), 27 cases (31 sides, 84%) remained stent patency. Twelve patients died from their primary malignancy carrying a patency stent. Stent migration was observed in 4 patients within 10 months after insertion. Ectopic stents were endoscopically removed and replaced successfully. Three stents were occluded, and no encrustation was seen in our study. Three and four patients had postoperative fever and gross hematuria, respectively. Infection was observed in 2 cases, mandating antibiotics therapy. In addition, postoperative volume of hydronephrosis postoperatively was significantly reduced compared with preoperation (54.18 ± 15.42 vs 23.92 ± 8.3, P = 0.019). However, no statistically significant differences regarding GFR, creatinine levels, blood urea nitrogen and hemoglobin existed between preoperation and last follow-up. Conclusions The current study demonstrated that metal ureteral stent is effective and safe in the treatment of stricture following surgery and/or radiation therapy for malignant cancer. Patients hydronephrosis could be improved by the stent placement.

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Section: Discussioncontrasting

confidence: 83%

Section: Discussioncontrasting

confidence: 83%

Metal stent for the ureteral stricture after surgery and/or radiation treatment for malignancy

et al. 2021

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“…Proper and timely treatment of a migrated stent can avoid injury to the transplanted kidney. RCEMS placement is recommended for TUS refractory to simple stenting [ 12 ]. Cao et al reported an 87.5% successful rate and 25% migration rate for RCEMS implanted for TUS [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for migration of retrievable covered expandable metallic stent in patients with persistent benign ureter strictures

Xu,

Li,

Cai

et al. 2024

World J Urol

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Purpose The purpose of this study is to evaluate the incidence, risk factors, and salvage management of retrievable covered expandable metallic stent (RCEMS) migration in patients with persistent benign ureter strictures. Materials and methods A retrospective study was performed on 117 consecutive patients who underwent implantation of RCEMS. Univariate and multivariate analyses were used to identify prognostic factors for stent migration, including stricture location and length, hydronephrosis–cortex ratio, ureteral dilation, and the diameter of the narrowest portion of the stricture. Results Stent migration occurred in 22 (19.5%) of 113 patients who met inclusion criteria. Of the 22 patients, 16 (72.7%) had ordinary ureteral stricture, 3 (13.6%) had stricture in transplanted kidneys, and 3 patients (13.6%) had ureter stricture in orthotopic neobladders. The mean creatinine for the entire cohorts showed significant improvement (p = 0.038). Multivariate analysis identified the following prognostic factors for migration: distal ureteral stricture (p = 0.006), patients who underwent balloon dilation (p = 0.003), hydronephrosis–cortex ratio ≧10 (p = 0.017), larger diameter of wasting of RCEMS (p < 0.001), and patients with a shorter stricture length (p = 0.006). Salvage management was required in 4 of the 22 patients. The strictures in the remaining 18 patients improved with observation. Conclusions Stent migration is more likely to occur in patients with the five prognostic factors mentioned above. Our study developed a nomogram to predict stent migration in patients with ureteral strictures treated using RCEMS.

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“…The above results indicate that the success rate of MUS does not reduce in recurrent ureteral strictures. Moreover, for ureteral atresia cases, endoureterotomy by holmium laser was applied to incise the scar tissue, and then the balloon dilation and stent insertion were performed as described before (21).…”

Section: Discussionmentioning

confidence: 99%

Initial Experience of Self-Expanding Metal Ureteral Stent in Recurrent Ureteral Stricture After Ureteroplasty

et al. 2021

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Background: The aim of this prospective study was to assess the safety and effectiveness of self-expanding metal ureteral stent (MUS) for the treatment of recurrent ureteral stricture after ureteroplasty.Methods: We prospectively included 24 patients who underwent MUS implantation between February 2019 and August 2020. The inclusion criteria for the procedure were recurrent ureteral strictures after ureteroplasty. A paired T test was used to compare continuous variables before and after surgery.Results: A total of 24 patients were finally included in this study. The stricture site was most common on the proximal ureter 19 (79.2%), followed by distal ureter 4 (16.7%) and middle ureter 1 (4.2%). The median length of ureteral stricture is 2.5 (range 1–18) cm. The median operative time was 51.5 min, and the median hospital stay time after surgery was 3 days. Post-operative complication included pain 1 (4.2%), urinary tract infection 2 (8.3%) and hematuria 2 (8.3%). After a median follow-up of 12 months, 19/24 (83.3%) patients were clinically and radiologically successful. We endoscopically adjusted or exchanged the failed stents. The volume of hydronephrosis (124.7 ± 132.5 vs. 66.4 ± 73.2 cm3, P = 0.015), blood creatinine level (104.5 ± 45.4 vs. 80.1 ± 23.2 μmol/L, P = 0.044) and urea nitrogen level (6.9 ± 2.4 vs. 4.8 ± 1.5 mmol/L, P = 0.003) decreased significantly after a median follow-up of 12 months.Conclusions: MUS is a safe and effective way to manage recurrent ureteral strictures after ureteroplasty. This technique provides a new choice for the treatment of recurrent stricture.

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Initial experiment of self-expanding metal ureteral stent in recurrent ureteral stenosis after kidney transplantation

Cited by 6 publications

References 4 publications

Metal stent for the ureteral stricture after surgery and/or radiation treatment for malignancy

Metal stent for the ureteral stricture after surgery and/or radiation treatment for malignancy

Risk factors for migration of retrievable covered expandable metallic stent in patients with persistent benign ureter strictures

Initial Experience of Self-Expanding Metal Ureteral Stent in Recurrent Ureteral Stricture After Ureteroplasty

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