title: Initial clinical experience with full-length metal ureteral stents for obstructive ureteral stenosis.
abstract: 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.
authors.affiliation: Department of Urology, University of Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany. Udo.Nagele@med.uni-tuebingen.de
authors.forename: Udo
authors.initials: U
authors.lastname: Nagele
authors.forename: Markus A
authors.initials: MA
authors.lastname: Kuczyk
authors.forename: Marcus
authors.initials: M
authors.lastname: Horstmann
authors.forename: Jörg
authors.initials: J
authors.lastname: Hennenlotter
authors.forename: Karl-Dietrich
authors.initials: KD
authors.lastname: Sievert
authors.forename: David
authors.initials: D
authors.lastname: Schilling
authors.forename: Ute
authors.initials: U
authors.lastname: Walcher
authors.forename: Arnulf
authors.initials: A
authors.lastname: Stenzl
authors.forename: Aristotelis G
authors.initials: AG
authors.lastname: Anastasiadis
mesh_terms: 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