Outcomes of patients with ureteral obstruction who achieved stent-free state following balloon dilatation.
OBJECTIVE
The aim of this study was to assess the therapeutic role of ureteral stent removal following balloon dilatation (BD) in patients with a stent implanted for unilateral ureteral obstruction and with normal contralateral renal function.


METHODS
This retrospective cohort study consisted of 37 consecutive patients with unilateral ureteral obstruction whose stents were removed after BD. All patients satisfied the following criteria: normal contralateral renal function, no evidence of malignancy, and the patient was eager to obtain a stent-free state (SFS) without invasive treatment. The relative function of the affected kidney and total renal function before and after stent removal were analyzed using renal scans and estimated glomerular filtration rate (eGFR). A successful outcome was defined as SFS without pain or febrile urinary tract infection plus maintenance of eGFR.


RESULTS
The mean age of all patients was 58.2 years. The mean follow-up periods before and after stent removals were 15.7 and 23.6 months, respectively. The most common underlying cause of ureteral obstruction was pelvic or abdominal surgery (51.4%). Of the 37 patients, 32 (86.5%) achieved successful SFS at last follow-up. Overall in the 37 patients, the eGFR (from 77.1 to 69.8 ml/min/1.73 m(2); p = 0.017) and relative renal function of the affected kidney (from 35.5 to 30.2%; p = 0.002) were significantly compromised. However, the reduction in total eGFR was not significant (p = 0.075) in the successful SFS group.


CONCLUSIONS
The removal of a stent with BD is a viable option for achieving a successful SFS in patients with unilateral ureteral obstruction.
a Department of Urology , University of Ulsan College of Medicine, Asan Medical Center , Seoul , Republic of Korea ;
Myong
M
Kim
b Department of Urology , Kangwon National University Hospital , Chuncheon , Republic of Korea ;
Geehyun
G
Song
c Department of Urology , Haeundae Paik Hospital, Inje University College of Medicine , Busan , Republic of Korea.
Sang Hyun
SH
Park
a Department of Urology , University of Ulsan College of Medicine, Asan Medical Center , Seoul , Republic of Korea ;
Mooyoung
M
Sohn
a Department of Urology , University of Ulsan College of Medicine, Asan Medical Center , Seoul , Republic of Korea ;
Sang Hoon
SH
Song
a Department of Urology , University of Ulsan College of Medicine, Asan Medical Center , Seoul , Republic of Korea ;
Hyung Keun
HK
Park
a Department of Urology , University of Ulsan College of Medicine, Asan Medical Center , Seoul , Republic of Korea ;
Bumsik
B
Hong
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization; D015331:Cohort Studies; D020878:Device Removal; D004106:Dilatation / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000628:therapy*
Balloon dilatation; complications; obstruction; stents; ureteral stricture