Retrograde transileal conduit stent placement for obstructed uropathy--success of primary and exchange stent placement.
OBJECTIVE
To assess the safety, success, and complications associated with retrograde ureteric stent insertion via the ileal conduit.


METHODS
The study population comprised 35 consecutive patients (17 men and 18 women; mean age, 55 y; age range, 40-75 y) requiring primary (20 stents) and exchange (70 stents) retrograde ureteric stent insertion via the ileal conduit over a 3-year period. Patient demographic data, procedural and technical data, and clinical follow-up data were collected.


RESULTS
Technical success was 90% (18 of 20) for primary stent placement and 100% (70 of 70) for stent exchange. There were two immediate complications (< 24 h) of sepsis and ureteric injury and one early complication (> 25 h but < 30 d) of sepsis requiring observation and medical management. Difficult procedures (defined as a fluoroscopy screening time > 31 min) and technical failures were found to be associated with encrusted stents visualized on prior computed tomography (P = .012), increased length of ileal conduit (> 20 cm) (P = .023), and ileal conduit kink (< 90 degrees) (P = .032). Only the occurrence of encrusted stents visualized on prior computed tomography (P = .022) was associated with complications.


CONCLUSIONS
Retrograde placement of ureteric stents via the ileal conduit is safe and effective. Retrograde stent placement should be considered the treatment option of choice for a first-time occurrence of obstructive uropathy at the ureteroileal anastomosis.
Department of Radiology, Oxford University Hospitals, John Radcliffe Hospital, Headington, Oxford, OX3 9DU, UK; Department of Radiology, Oxford University Hospitals, Churchill Hospital, Headington, Oxford, United Kingdom. Electronic address: charles.tapping@ouh.nhs.uk.
Charles Ross
CR
Tapping
Department of Radiology, Oxford University Hospitals, John Radcliffe Hospital, Headington, Oxford, OX3 9DU, UK.
James H
JH
Briggs
Department of Radiology, Oxford University Hospitals, John Radcliffe Hospital, Headington, Oxford, OX3 9DU, UK.
Mark W
MW
Little
Department of Radiology, Oxford University Hospitals, John Radcliffe Hospital, Headington, Oxford, OX3 9DU, UK.
Mark J
MJ
Bratby
Department of Radiology, Oxford University Hospitals, John Radcliffe Hospital, Headington, Oxford, OX3 9DU, UK; Department of Radiology, Oxford University Hospitals, Churchill Hospital, Headington, Oxford, United Kingdom.
Jane
J
Phillips-Hughes
Department of Urology, Oxford University Hospitals, Churchill Hospital, Headington, Oxford, United Kingdom.
Jeremy P
JP
Crew
Department of Radiology, Oxford University Hospitals, Churchill Hospital, Headington, Oxford, United Kingdom.
Phil
P
Boardman
D000328:Adult; D000368:Aged; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014513:Ureter / Q000293:injuries; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000628:therapy*; D014547:Urinary Diversion / Q000009:adverse effects*; D014947:Wounds and Injuries / Q000209:etiology