Expandable metallic ureteral stent: indications and results

Sampogna, G.; Grasso, Angelica; Montanari, Emanuele

doi:10.23736/s0393-2249.18.03035-7

Cited by 13 publications

(22 citation statements)

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“…In recent years, drug-eluting expandable metal stents and biodegradable stents have emerged owing to the prevalence of USRS, stent encrustation, stent migration and stent-related urinary tract infection (32,33). To promote stent development and avoid ureteral stent migration to the contralateral side to trigger severe USRS, can we focus stent innovation on limiting stent migration?…”

Section: Discussionmentioning

confidence: 99%

Distal end of Double-J ureteral stent position on ureteral stent-related symptoms: A systematic review and meta-analysis

et al. 2022

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BackgroundMost patients suffer from ureteral stent-related symptoms (USRS) caused by indwelling ureteral stents. Nevertheless, various medications to alleviate discomfort as well as novel stents are continually being developed, and in recent years, some researchers have believed that proper intravesical stent placement can relieve USRS.ObjectiveTo determine appropriate intravesical ureteral stent position may alleviate USRS.MethodsUp to May 1, 2022, the PubMed, Embase, Scopus and Web of Science databases were thoroughly searched, and two independent reviewers included relevant studies that met the PICO (Patient, Intervention, Comparison, Outcome) criteria. Studies methodological quality were assessed by ROB2 and ROBINS-I. Ureteral stent symptom questionnaire (USSQ), international prostate symptom score (IPSS) and quality of life (QoL) was used to quantify the USRS. According to intravesical ureteral stent position, Group A was defined as the contralateral group, that is distal end of ureteral stent crossed the bladder midline, whereas Group B was classified as ipsilateral group, meaning stent end did not cross the midline.ResultsSix studies incorporating a total of 590 patients were eligible. In terms of USSQ score, the meta-analysis showed that contralateral group was associated with a significant increase in USSQ total (MD, 17.55; 95% CI, 12.04 to 23.07; P < 0.001), urinary symptoms (MD, 2.74; 95% CI, 0.48 to 5.01; P = 0.02), general health (MD, 4.04; 95% CI, 2.66 to 5.42; P < 0.001), work performance (MD, 1.36; 95% CI, 0.75 to 1.98; P < 0.001) and additional problems (MD, 0.89; 95% CI, 0.47 to 1.32; P < 0.001) scores while not associated with a significant increase in body pain (MD, 3.13; 95% CI, −0.19 to 6.44; P = 0.06) and sexual matters (MD, 1.01; 95% CI, −0.03 to 2.06; P = 0.06). As for IPSS, although no significant differences in IPSS total (MD, 2.65; 95% CI, −0.24 to 5.54; P = 0.07) or voiding symptoms (MD, −0.84; 95% CI, −3.16 to 1.48; P = 0.48) scores were found, ipsilateral group was associated with a significant decrease in storage symptoms (MD, 1.92; 95% CI, 0.91 to 2.93; P = 0.0002). Furthermore, ipsilateral group was linked to a significant decrease in QoL score (MD, 1.00; 95% CI, 0.18 to 1.82; P = 0.02).ConclusionThis meta-analysis proven that correct intravesical stent position was critical, and patients with stents crossing the midline experienced more severe USRS than those who did not. Further high-quality randomized controlled trials are needed to corroborate our findings.

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Section: Discussionmentioning

confidence: 99%

Distal end of Double-J ureteral stent position on ureteral stent-related symptoms: A systematic review and meta-analysis

et al. 2022

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“…Traditionally, the surgical treatment of ureteral strictures included uretero-ureteral anastomosis, ileal substitution, autotransplant, or, in some cases, an indwelling stent or nephrostomy tube (11). Thanks to technological evolution, endoscopic treatments such as balloon dilation, cold knife incision, and laser endoureterotomy are more becoming more common, including the new types of ureteral metallic stent placement (12). The Allium ™ stent is a newly developed ureteral stent, which can be inserted in structures of a small diameter and spontaneously expands and preserves a large caliber.…”

Section: Discussionmentioning

confidence: 99%

Allium stent as a curative treatment for benign ureteral strictures: Preliminary experience, surgical technique, and functional results

Salciccia¹,

Marco²,

Sciarra³

et al. 2022

Front. Urol.

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ObjectivesTo evaluate the effectiveness and safety of the Allium™ ureteral stent as a curative treatment of benign ureteral strictures.Materials and methodsWe retrospectively reviewed the electronic database of the two centers of patients who underwent ureteral Allium™ positioning for different types of stenosis (benign or malignant). Between April 2017 and May 2021, 151 patients were treated with the Allium™ stent for ureteral strictures including benign and malignant stenosis. In total, 83 of them met the inclusion criteria for benign ureteral stricture and were included in final analysis.ResultsAbout the etiology of strictures, 79 (95.18%) were secondary to ureteroscopy or impacted stones and 4 (4.82%) were secondary to pelvic surgery. The median operating time was 47.9 ± 15.53 min, and the median length of strictures was 2.51 ± 0.84 (1-4) cm. The median time of follow-up was 18 months (range 1–48 months), the overall success rate was 85.5% (71/83), and no intraoperative or perioperative major complications were recorded. Among patients with failure (12 pts, 14.5%): 10 (83.33%) presented ureteral strictures again; among them, 8/10 were patients with a stricture length between 2 and 4 cm, 2 (16.67%) patients with pyelus–ureteral junction stenosis experienced the migration of the stent. All patients who experienced failure were treated surgically either with a robotic or laparoscopic approach.ConclusionsIn our preliminary experience, the Allium™ stent seems to be an effective and safe surgical treatment for benign ureteral stricture. Further analysis and prospective trials are necessary to better define the role of the Allium™ stent in the treatment of benign ureteral strictures.

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“…Deposition of crystal in the stent lumen can block drainage and interact with the ureter's urothelial lining, causing ureteral trauma. Furthermore, prolonged ureteral stent retention was linked to a higher chance of chronic renal disease and hospitalization for UTI (urinary tract infection) or septicemia following the removal of the stent [3][4][5].…”

Section: Encrustationmentioning

confidence: 99%

Application, Advancement, and Complication of Ureteral Stent and Encrustation: A Major Complication

Bhardwaj¹,

Ingole²

2022

Cureus

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Three technological aspects have a significant impact on the functioning of an optimal stent. The substance it is made up of, model or design, and coating of the surface are important areas for research. To give recognition of an ideal stent, it summarizes some essential breakthroughs that occurred. Encrustation is a regular problem that can happen when a ureteral stent is implanted in the urinary tract, and it may be dangerous. The part of the paper covers the mechanism of encrustation, stent management, and the most recent technologies created to solve this problem. Encrustation has a complicated and diverse mechanism that includes the time it stays inside, patient-specific risk factors, controlled film production, formation of biofilm, and deposition of minerals. A number of high-tech advancements in stent substances and coverings/coatings could help to reduce the danger of encrustation of stents. It's critical to determine the amount of encrustation of a stent so that therapy options can be tailored properly. For the care of ureteral stents, which are encrusted, we offer a unique therapeutic protocol. The duration of stent indwelling time has been repeatedly established to be a critical risk factor for the evolution of encrustation. The period of stent indwelling time has consistently been established to be a critical risk element for the evolution of encrustation. Patients who are predisposed to bacteriuria and urinary lithiasis are also predisposed to encrustation. Repeated urinary tract infections, diabetes, and chronic kidney failure are among the factors that might escalate urine bacterial load, which can lead to stent encrustation. Due to the prevalence of ureteral stents in urology, it's critical to keep up to date on the best ways to prevent stent encrustation, recognize high-risk patients, and remove them using multimodal techniques.

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Expandable metallic ureteral stent: indications and results

Cited by 13 publications

References 0 publications

Distal end of Double-J ureteral stent position on ureteral stent-related symptoms: A systematic review and meta-analysis

Distal end of Double-J ureteral stent position on ureteral stent-related symptoms: A systematic review and meta-analysis

Allium stent as a curative treatment for benign ureteral strictures: Preliminary experience, surgical technique, and functional results

Application, Advancement, and Complication of Ureteral Stent and Encrustation: A Major Complication

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