The resonance® metallic ureteric stent in the treatment of chronic ureteric obstruction: a safety and efficacy analysis from a contemporary clinical series

Patel, Chintan; Loughran, Dafydd; Jones, Rachel; Abdulmajed, Mohamed Ismat; Shergill, Iqbal

doi:10.1186/s12894-017-0204-8

Cited by 20 publications

(12 citation statements)

References 23 publications

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“…Patel et al 5 reported 12 months median indwelling time of Resonance ® stent in the malignant ureteral obstruction group and 19 months in the non-malignant group of a 52 cases series. But most of the retrospective and prospective studies between the years of 2013 to 2016 report a median duration of 5-12 months.…”

Section: Discussionmentioning

confidence: 99%

Antegrade Access Placement of Resonance? Metallic Double-J Stent in Ureteral Obstruction: A Case Report

Tanisaro¹

2018

bkkmedj

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U reteral obstruction is caused by several conditions. Benign causes are more common than malignant ones, and bladder and kidney stones and prostate hyperplasia occur in the majority of cases. The most common malignant causes are cervical cancer, bladder cancer, uterine cancer and colon cancer. External compression or extrinsic causes include retroperitoneal fibrosis and post radiation complications.Surgical treatment is the modality of choice for most conditions. Occasionally, conservative treatments of either endoscopic or percutaneous interventions are considered. Retrograde DJS is more commonly used than percutaneous nephrostomy (PCN). Studies have not shown any clinical advantages of DJS over PCN in terms of safety rates (major complications) 1 or comfort (quality of life scoring). 2 That said, most patients and physicians continue to favor DJS over PCN.Plastic-based materials in DJS and nephrostomy tubes are either made of silicone, polyethylene and/or polyurethane but the latter proves to be the most durable. The median durability of both DJS and PCN is less than 6 months. Causes of a non-functioning stent stem from either encrustation or obstruction that may be connected to bacteriuria that may in turn lead to septicemia or sepsis which is the most serious complication. Biofilm occurred in 60-90% of cases leading to bacteriuria in 30%. E.coli and enterococcus are found in 44% of all colonizations. 3 Normally, there are three (3) stages in developing biofilm: 1) endogenous protein deposition; 2) bacterial attachment and; 3) development of biofilm structure. In any case, tumor ingrowth or over-growth are mechanisms of obstruction in most malignancies. Other major complications besides infection range from hematuria, bladder spasm, dysuria and flank pain. Most guidelines recommend a stent exchange every three (3) to six (6) months.The tubed-or self-expandable metallic stent has been reported in cases of ureteral obstruction for more than a decade such as the WALL stent, Nitinol stent or other newly developed metallic stents. Stent migration is still the major problem in 30% of cases. 4 AbstractRetrograde or endoscopic approach of Double-J stent (DJS) is still the most favorable choice of treatment in both benign and malignant ureteral obstruction. Percutaneous nephrostomy (PCN) is, however, an alternative to DJS placement. Antegrade placement of DJS (either plastic or metallic) can be done easily with no particularly significant complication when the PCN tube is already placed in the kidney. The metallic DJS or Resonance ® stent is probably preferable to the plastic DJS in terms of median life span and cost effectiveness. We report on cases with the use of metallic DJS or Resonance ® stent in patients with failed placement of the DJS via either a retrograde or endoscopic route. We summarize the demographic data of four (4) cases of antegrade placement of metallic DJS.

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Section: Discussionmentioning

confidence: 99%

Antegrade Access Placement of Resonance? Metallic Double-J Stent in Ureteral Obstruction: A Case Report

Tanisaro¹

2018

bkkmedj

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“…The patency rate of metallic stents for the treatment of MUO lies between 37% and 100% [16–21], and the success rate of the operation is 96% [22], according to literature reports. In our study, the success rate of metallic stent catheterization was 96.9%.…”

Section: Discussionmentioning

confidence: 99%

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

Chen

Liu

et al. 2019

World J Surg Onc

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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.

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“…In the last 2 years we have replaced wallstents with thermoexpandable metallic stents (Memokath, PNM Medical, Denmark [8][9][10][11]). …”

Section: Methodsmentioning

confidence: 99%

Metallic Ureteric Stents a cost-effective alternative in the management of Obstructed Distal Ureters

Lang¹

2017

J Radiol Oncol

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The resonance® metallic ureteric stent in the treatment of chronic ureteric obstruction: a safety and efficacy analysis from a contemporary clinical series

Cited by 20 publications

References 23 publications

Antegrade Access Placement of Resonance? Metallic Double-J Stent in Ureteral Obstruction: A Case Report

Antegrade Access Placement of Resonance? Metallic Double-J Stent in Ureteral Obstruction: A Case Report

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

Metallic Ureteric Stents a cost-effective alternative in the management of Obstructed Distal Ureters

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