Initial clinical experience with full-length metal ureteral stents for obstructive ureteral stenosis.
OBJECTIVE
Long-term ureteral stenting is used to ensure urinary drainage if a reconstructive approach or a release of an extrinsic obstruction is not possible. In this contribution, a long-term experience with a new full-length, metal indwelling stent is presented.


METHODS
Fourteen patients with ureteral obstruction received full metal indwelling stents in 18 collecting systems (benign disease in 5 and malignant disease in 13). Stent placement was performed cystoscopically under fluoroscopic guidance. Follow-up was done every 3 months with ultrasonographic examination, creatinine levels, and a visual analog pain score.


RESULTS
Eight stents were removed, whereas eight are still in situ. One patient without stent-related problems died because of progressive rectal cancer 9 months after bilateral stent insertion. Mean stent duration (8 stents still in situ) is 8.6 months, whereas mean stent duration for benign and malignant disease is 11.8 (median 13) and 7.3 (median 6) months, respectively (p<0.05). All removed stents were extracted endoscopically without any problems and had no incrustation except two. Neither migration nor mechanical damage was observed.


CONCLUSIONS
This novel stent is easy to insert and remove. It is an option for patients in which a surgical reconstruction of the obstructed ureter is not possible. Stents have been developed further and are now available in various lengths. This might result in a reduction of problems associated with inadequate stent length and should increase patient comfort and stent durability.
Nagele
Udo
U
Department of Urology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany. Udo.Nagele@med.uni-tuebingen.de
Kuczyk
Markus A
MA
Horstmann
Marcus
M
Hennenlotter
Jörg
J
Sievert
Karl-Dietrich
KD
Schilling
David
D
Walcher
Ute
U
Stenzl
Arnulf
A
Anastasiadis
Aristotelis G
AG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003558:Cystoscopy / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000295:instrumentation*; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000601:surgery*; D014567:Urography