Initial Experience of Self-Expanding Metal Ureteral Stent in Recurrent Ureteral Stricture After Ureteroplasty

Abstract

Background: The aim of this prospective study was to assess the safety and effectiveness of self-expanding metal ureteral stent (MUS) for the treatment of recurrent ureteral stricture after ureteroplasty.Methods: We prospectively included 24 patients who underwent MUS implantation between February 2019 and August 2020. The inclusion criteria for the procedure were recurrent ureteral strictures after ureteroplasty. A paired T test was used to compare continuous variables before and after surgery.Results: A total of 24 patients were finally included in this study. The stricture site was most common on the proximal ureter 19 (79.2%), followed by distal ureter 4 (16.7%) and middle ureter 1 (4.2%). The median length of ureteral stricture is 2.5 (range 1–18) cm. The median operative time was 51.5 min, and the median hospital stay time after surgery was 3 days. Post-operative complication included pain 1 (4.2%), urinary tract infection 2 (8.3%) and hematuria 2 (8.3%). After a median follow-up of 12 months, 19/24 (83.3%) patients were clinically and radiologically successful. We endoscopically adjusted or exchanged the failed stents. The volume of hydronephrosis (124.7 ± 132.5 vs. 66.4 ± 73.2 cm3, P = 0.015), blood creatinine level (104.5 ± 45.4 vs. 80.1 ± 23.2 μmol/L, P = 0.044) and urea nitrogen level (6.9 ± 2.4 vs. 4.8 ± 1.5 mmol/L, P = 0.003) decreased significantly after a median follow-up of 12 months.Conclusions: MUS is a safe and effective way to manage recurrent ureteral strictures after ureteroplasty. This technique provides a new choice for the treatment of recurrent stricture.

Long-term maintenance treatment of recurrent ureteropelvic junction obstruction with covered metallic ureteral stent

“…[ 5 ] However, our covered metallic ureteral stent migration rate is higher than a previous study using a covered metallic ureteral stent to treat recurrent ureteral stricture after ureteroplasty with a stent migration rate of 12.5% (3/24). [ 25 ] The previous study includes a total of 24 patients with recurrent stricture after ureteroplasty (pyeloplasty 14 patients, ureteroureterostomy 5 patients, ileal flap ureteroplasty 1 patient, buccal mucosa graft ureteroplasty 2 patients, and ureteral bladder replantation 2 patients). This suggests that the length, severity, and location of ureteral stricture may also affect the clinical outcome of the covered metallic ureteral stent.…”

Metal ureteral stents for ureteral stricture: 2 years of experience with 246 cases

“…MUS offer several advantages over traditional techniques, including a lower risk of complications and a higher success rate in preventing stricture recurrence 8 . In addition, MUS have emerged as a promising treatment option for recurrent ureteral strictures due to their durability and long-term patency rates 9 .…”