Extra‐anatomic stents in ureteric obstruction: experience and complications

Abstract

In patients with ureteric obstruction secondary to malignancy or medical conditions excluding them from more invasive surgery, EAS provide a further therapeutic option instead of a permanent nephrostomy, which has associated inherent problems. This technique is not without potential problems and careful selection of patients remains vital in this difficult area.

The role of percutaneous nephrostomy in malignant ureteric obstruction

“…3 However, drainage of such an obstructed system leads to an ethical dilemma -is such drainage going to facilitate treatment with chemotherapy or radiotherapy, or is it perpetuating and allowing other problems to develop?…”

Extra-Anatomic Urinary Drainage for Urinary Obstruction

“…It was also the first time in the literature that an EAS had been used in a patient with a benign stricture of a native ureter. The patient remained well and was alive to the end of the study at 24 months (Minhas et al, 1999). Since this original publication, we have implanted over one hundred EAS in candidate patients at our institution with equally excellent results (unpublished series).…”

“…Different types of EAS have been developed and used successfully by different authors (Lingam, 1994;Minhas, 1999;Desgrandchamps, 1998a;, Lloyd, 2007). The designs have varied with the materials used, length of stent, diameter of stent and on whether one or composite stent/s are utilized.…”

“…The guide-wire is then passed into the bladder via the distal end of the old stent, which is then removed. The distal end of the new stent is passed over the wire into the bladder and the guide-wire removed endoscopically from the distal end of the stent (Minhas et al, 1999). …”

“…Several authors have reported their experience of using extra-anatomical stents (EAS) for temporary or permanent drainage of obstructed urinary tracts (Ahmadzadeh, 1991;Lingam et al, 1994;Nakada et al, 1995;Desgrandchamps et al, 1998aDesgrandchamps et al, 1998bMinhas et al, 1999;Lloyd et al, 2007). In this chapter, we describe the indications for and the technique of inserting the EAS, and a review of the results from the major series.…”