Double-ended Pigtail Polyethylene Stents in Management of Benign and Malignant Ureteric Obstruction

Pa, Jones; Pittam, M.; Moxon, Richard; Edwards, Laura

doi:10.1177/014107688307600605

Cited by 9 publications

(1 citation statement)

References 16 publications

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“…The use of double J stents is now routine in urological practice, the main indications being benign and malignant strictures, obstruction due to stones, ureteric injury, prophylaxis following surgery and acute hydronephrosis of pregnancy (Finney, 1978; Read at the Combined Meeting of the British Association of Urological Surgeons and the Canadian Urological Association in London, June 1986 _ --_ _ _ _~~ Lang et al, 1979;Mardis et al, 1982;Ball et al, 1983;Jones et al, 1983;Laverson et al, 1984;Lang, 1984;Andriole et al, 1984).…”

mentioning

confidence: 99%

Double J Stents: A Review of 100 Patients

Pocock

Stower

Ferro

et al. 1986

British Journal of Urology

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Double J stents have been advocated for drainage or splintage of the ureter. One hundred and thirty-eight attempts at stent insertion were made in 100 patients. In 78% of attempts the stent was satisfactorily placed. Their use in retroperitoneal fibrosis, ureteric trauma and acute hydronephrosis of pregnancy has been encouraging. Poor results have been obtained in patients with malignant obstruction or tuberculous stricture.

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mentioning

confidence: 99%

Double J Stents: A Review of 100 Patients

Pocock

Stower

Ferro

et al. 1986

British Journal of Urology

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Intermittent claudication caused by retroperitoneal fibrosis

Shortland

Archer

Webster

1986

British Journal of Surgery

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A 54-year-old man was referred to the Vascular Unit for the assessment of intermittent claudication. He complained of right sided calf pain which had increased in severity over 13 months. The pain limited his walking to 150 yards and radiated to the thigh and buttock. He reported diminished sexual potency. Four years earlier he smoked 20 cigarettes a day but by the time of his first consultation he had reduced this to 4 a day. He did not suffer from diabetes mellitus and, with the exception of inositol nicotinate (Hexopal) 500 mg t.d.s. for three months, had received no medication.The legs looked and felt normal; however, popliteal, posterior tibia1 and dorsalis pedis pulses were absent on both sides. The right femoral pulse was weak and there was a bruit over the left femoral artery. Systolic blood pressure was 140 mmHg and diastolic 80 mmHg. Appropriate biochemical and haematological variables were all normal, however, erythrocyte sedimentation rate was not measured. Serum concentration of the following variables was: urea 5.21 mmol/l; sodium 141 mmol/l; potassium 3.87 mmol/l; creatinine 105 pmol/l; random glucose 5.3 mmol/l; cholesterol 6.2 mmolil; triglycerides 1.8 mmol/l; haemoglobin concentration was 15.5 g/dl.Arteriography by the Seldinger technique showed irregular narrowing of the distal aorta and both iliac systems. This was most severe in the right common iliac artery. (Figure I) Below the inguinal ligaments the arteries were relatively normal.An aorto-iliac endarterectomy was undertaken, however, at operation a dense sheet of fibrous tissue was found to surround both common iliac arteries and the right ureter. The aorta was slightly affected by atheroma but the iliac arteries were relatively spared. Dissection of the aorto-iliac system proved to be technically difficult because of the dense fibrous tissue rather than the modest amount of atheroma. An aortobifemoral bypass graft was therefore inserted and both ureters were freed from the fibrous tissue, placed laterally and wrapped in omentum.Intravenous urography after surgery showed post-obstructive atrophy of the right kidney and an enlarged left kidney (Figure 2). The ureters were satisfactorily placed. Three months after surgery the patient had returned to work and was free from intermittent claudication, although his sexual potency was still impaired. The intravenous urogram was unchanged. DiscussionRetroperitoneal fibrosis is a very unusual cause of lower limb arterial ins~fficiency'-~ and is most likely t o be encountered unexpectedly during another procedure. It is, however, associated with vascular disease arising in about 7 per cent of aortic aneurysms'. These are known as inflammatory aneurysms and a sheet of fibrous tissue, macroscopically indistinguishable from retroperitoneal fibrosis, envelops the aorta #and may spread to obstruct the ureters. The pathogenesis is unknown. It has been suggested that the primary problem is due to inflammatory changes in the wall of the aneurysm which extend to the surrounding tissues2.Alternatively, the m...

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Radiology

O'reilly¹,

Rickards²

1986

Obstructive Uropathy

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Double-ended Pigtail Polyethylene Stents in Management of Benign and Malignant Ureteric Obstruction

Cited by 9 publications

References 16 publications

Double J Stents: A Review of 100 Patients

Double J Stents: A Review of 100 Patients

Intermittent claudication caused by retroperitoneal fibrosis

Radiology

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