Metal Ureteral Stent for Benign and Malignant Ureteral Obstruction

Abstract

Metal ureteral stents are effective for benign and malignant ureteral obstruction in the absence of urolithiasis. Good tolerability and annual stent exchange make metal stents an appealing alternative for patients with chronic ureteral obstruction treated with indwelling ureteral stents.

Outcomes of Metallic Stents for Malignant Ureteral Obstruction

“…followup at our center, the sample size of our series was small and underpowered for multivariate modeling. However, this series of 37 stents is similar in size to most series recently published on this device, 11,12,14,15 and the first to focus exclusively on MUO. In addition, it would be interesting to assess the impact of the metallic stent on health related quality of life in patients with MUO in a prospective trial setting.…”

“…[11][12][13][14][15] Overall failure rates in cohorts including MUO and nonMUO cases have ranged widely from 7% to 66%. [11][12][13][14][15] Of note, although no prior studies have focused exclusively on patients with MUO, this subset of patients was found to have higher failure rates in 3 previous series. 11,14,15 Other series have demonstrated equivalent 13 or even improved outcomes 12 in patients with MUO.…”

“…For this analysis our definition of failure was similar to comparable studies, [11][12][13][14][15] as unplanned stent exchange or nephrostomy tube placement for signs or symptoms of recurrent ureteral obstruction (recurrent hydroureteronephrosis or increasing creatinine). In applying this standard to our cohort of 37 stents placed for MUO, a failure rate of 35% was identified.…”

“…[11][12][13][14][15] Of note, although no prior studies have focused exclusively on patients with MUO, subset analyses revealed higher failure rates with MUO in multiple series. 11,14,15 Given the indefinite need for urinary diversion in MUO, these patients would benefit a great deal from more durable ureteral stents. Therefore, we reviewed the outcomes of this stent when placed specifically for MUO.…”

Biomaterials in Urology - Beyond Drug Eluting and Degradable - A Rational Approach to Ureteral Stent Design

“…Metal ureteral stents were introduced by Pauer in 1992 (Pauer and Lugmayr 1992) and have been utilized in the treatment of malignant ureteric obstruction (Kulkarni and Bellamy 2001;Liatsikos, Karnabatidis et al 2009;Masood, Papatsoris et al 2010;Papatsoris and Buchholz 2010;Sountoulides, Kaplan et al 2010), ureteral strictures (Daskalopoulos, Hatzidakis et al 2001;Papatsoris and Buchholz 2010), and ureteropelvic junction obstruction Masood, Papatsoris et al 2010;Benson, Taylor et al 2011). Current problems associated with metallic stents include biofilm formation, infection, migration, and tissue hyperplasia leading to luminal obstruction Wah, Irving et al 2007;Liatsikos, Karnabatidis et al 2009;Sountoulides, Kaplan et al 2010).…”