Malignant ureteral obstruction: experience and comparative analysis of metallic versus ordinary polymer ureteral stents

Abstract

Background To study the outcome and experience of using metallic stents in treating patients with malignant ureteral obstruction (MUO). Methods Seventy-six patients with MUO were assigned to the metallic stent group (MSG) or the ordinary polymer stent group (OPSG) according to the different materials. The success rate of the operation, duration of operation, patency rate serum creatinine values ,postoperative complications and QOL scores were compared between the two groups. Results In the OPSG and MSG, the success rates of the operation were 95.5% and 96.9%, respectively, and the durations of the operation were 20.6 ± 2.2 min and 50.9 ± 10.3 min ( P < 0.01), respectively. There was no significant difference between the groups in serum creatinine values at 3 days after the operation ( P > 0.05); however, the creatinine values at 3 days after the operation decreased significantly compared with those before the operation ( P < 0.01). In the OPSG, there was no significant difference in creatinine values between 3 days and 6 months after operation, while the creatinine values 1 year after operation were increased significantly compared to those at 3 days after the operation ( P < 0.05). In the MSG, there was no significant difference among creatinine values at different intervals ( P > 0.05). The total rate of post-procedural complication was lower in the MSG than that in the OPSG( P < 0.05). There was no significant difference in the QOL score between the two groups before the operation ( P > 0.05); however, the QOL scores at 6 months and 1 year after the operation were higher in the MSG than that in the OPSG( P < 0.05). In the MSG, there was no significant difference in the QOL score between preoperation and 6 months after surgery. Similarly, there was also no difference in the QOL score between 6 months after surgery and 1 year after surgery( P > 0.05). On the contrary, the differences of QOL score in the OPSG group were much significant between disparate time intervals ( P < 0.05). Conclusions For patients with MUO who require long-term retention of the stent, metallic stents with longer indwelling time are superior to ordinary polymeric stents.

Risk factors in the prediction of long‐term patency of Resonance metallic ureteric stent in malignant ureteric obstruction

“…Previous studies by Abbasi et al and Chow et al showed a mean duration of functioning metallic stent of 5.3 to 7.4 months 11‐14 . Others reported the one year patency rates of Resonance metallic stents in malignancy ureteric obstruction ranged from 60% to 91% 15‐18 …”

Stenting of Malignant Urinary Tract Obstructions in Humans and Companion Animals

“…These stents have historically consisted of a polymer tube with multiple fenestrations to allow drainage, but metallic ureteral stents have also been designed in numerous configurations. [4,5]. For these metallic stents, a metal coil may be embedded within the polymer; more recent designs are configured in a metallic spiral design.…”

“…Extraluminal ureteral compression can also occur from masses or lymphadenomegaly. Lastly, after radiation therapy in the region of the ureter, ureteral obstruction can result from fibrosis-induced stricture or alteration of ureteral elasticity with subsequent decreased peristaltic activity [4,5,21].…”

Roles Played by Biomarkers of Kidney Injury in Patients with Upper Urinary Tract Obstruction

“…A malignant ureteral obstruction develops secondary to a malignant tumor. A primary tumor may infiltrate the ureteral wall and compress the ureter, swollen lymph nodes may wrap around the ureter, edema and retroperitoneal fibrosis that develop after radiotherapy may distort the ureter or cause luminal stenosis, or ureter elasticity may be weakened [ 8 ]. The condition may be unilateral or bilateral.…”