title: Antegrade repositioning of Memokath stent in malignant ureteroileal anastomotic stricture.
abstract: Ureteric strictures are common and can be due to benign or malignant causes. Various surgical treatments can be used from minimally invasive endoscopic retrograde JJ stent insertion, balloon dilatation, ureterolithotomy, to open surgical exploration and repair. Memokath 051 stent is a metallic stent designed for long-term ureteral stenting in the management of ureteral strictures. The insertion of this device is usually a straightforward procedure performed endoscopically in a retrograde fashion via cystoscopy. However, this procedure can be difficult in complicated scenarios when the bladder has been removed with neoureteral reimplantations or high-grade strictures. Here, we report a case of Memokath stent insertion complicated by placement difficulties in a lady with ileal conduit due to previous ovarian cancer complicated by vesicovaginal fistula, who presented with malignant stricture of the ureteroileal anastomosis. We describe a simple yet effective antegrade technique to precisely reposition the malpositioned Memokath stent, along with illustrations.
authors.affiliation: Urology Unit, Department of Surgery, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia; Urology Department, Princess Alexandra Hospital, Queensland, Australia. Electronic address: kenglimng@yahoo.com.
authors.forename: Keng Lim
authors.initials: KL
authors.lastname: Ng
authors.affiliation: Department of Bioimaging, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
authors.forename: Ouzrieah
authors.initials: O
authors.lastname: Nawawi
authors.affiliation: Department of Bioimaging, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
authors.forename: Bee Kuan
authors.initials: BK
authors.lastname: Lim
authors.affiliation: Urology Unit, Department of Surgery, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
authors.forename: Thi Ha
authors.initials: TH
authors.lastname: Htun
authors.affiliation: Urology Unit, Department of Surgery, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
authors.forename: Norman
authors.initials: N
authors.lastname: Dublin
authors.affiliation: Urology Unit, Department of Surgery, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
authors.forename: Azad Hassan
authors.initials: AH
authors.lastname: Razack
mesh_terms: D015653:Cystectomy / Q000009:adverse effects / Q000379:methods; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery; D010052:Ovariectomy / Q000009:adverse effects / Q000379:methods; D011474:Prosthesis Design; D011475:Prosthesis Failure; D015642:Radiology, Interventional / Q000379:methods*; D019233:Retreatment / Q000379:methods; D018570:Risk Assessment; D015607:Stents; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000628:therapy*; D014547:Urinary Diversion / Q000009:adverse effects*
keywords: Memokath stent; antegrade; ureteroileal stricture