Retrograde Ureteral Stents for Extrinsic Ureteral Obstruction: Nine Years’ Experience at University of Michigan

Rosevear, Henry; Kim, Simon P.; Wenzler, David; Faerber, Gary J.; Roberts, William W.; Wolf, J. Stuart

doi:10.1016/j.urology.2007.07.008

Cited by 58 publications

(39 citation statements)

References 20 publications

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“…These results were in agreement with those of the study by Kamiyama et al (3). Such patients have more advanced tumor staging and their general health is poorer (10). As found in teh present study, many of them are unable to cooperate with their doctors, and cannot tolerate the pain associated with the procedure.…”

Section: Discussionsupporting

confidence: 93%

“…The use of ureteral stents to bypass the obstruction is common in clinical practice, and RUS is more advantageous than PCN, particularly in view of the limited life expectancy of patients with advanced malignancies (3,4,7). However, the incidence of insertion failure is markedly higher in cases of MUO, ranging from 15.0 to 27.5% (3)(4)(5)(6)(7)(8)(9)(10)(11)(12). This high failure rate may be associated with extrinsic compression or invasion of the ureter by tumors, which may lead to the bending and deformation of the ureter, which then increases resistance during intubation in the majority of advanced malignancies (15).…”

Section: Discussionmentioning

confidence: 99%

“…Stent failure was defined as any ureteral unit (UU) in which stent insertion failed or any UU that continued to cause symptoms for the patient after stent placement (3)(4)(5)(6)(7)(8)(9)(10)(11)(12). Stents were inserted by three experienced urological surgeons on an outpatient basis, using local anesthesia.…”

Section: Methodsmentioning

confidence: 99%

“…The advantages of this procedure are its simplicity and convenience, with no requirement for hospitalization, and a cheaper cost. However, cystoscopic ureteral stent insertion is a challenging procedure even for the most experienced urologists, with a mean failure rate of 15.0-27.5% (3)(4)(5)(6)(7)(8)(9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

“…While the majority of previous studies have focused on the factors for stent functional failure in patients with MUO, such as baseline levels of serum creatinine (SCr), degree of hydronephrosis and being male in gender (4,5,8), studies on the predictive factors for the failure of retrograde ureteral stent placement under local anesthesia in outpatients have been rare (10).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Predicting the failure of retrograde ureteral stent insertion for managing malignant ureteral obstruction in outpatients

et al. 2015

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Abstract. Malignant ureteral obstruction (MUO) is an unpropitious sign that is commonly observed in patients with advanced incurable cancer. The present study aimed to evaluate predictive factors for the failure of retrograde ureteral stent insertion in the management of MUO in outpatients. A total of 164 patients with MUO were retrospectively assessed in this study. Clinical factors, including age, gender, type of malignancy, level of obstruction, cause of obstruction, pre-operative creatinine level, degree of hydronephrosis, condition of the contralateral ureter, prior radiotherapy, Eastern Cooperative Oncology Group performance status (ECOG PS), bladder wall invasion and technical failure, were recorded for each case. Univariate and multivariate logistic regression analyses were used to investigate the risk factors for predicting the failure of retrograde ureteral stent insertion. In total, 38 out of 164 patients experienced bilateral obstruction, therefore, a total of 202 ureteral units were available for data analysis. The rate of insertion failure in MUO was 34.65%. Multivariate analyses identified ECOG PS, degree of hydronephrosis and bladder wall invasion as independent predictors for insertion failure. Overall, the present study found that rate of retrograde ureteral stent insertion failure is high in outpatients with MUO, and that ECOG PS, degree of hydronephrosis and bladder invasion are potential independent predictors of insertion failure.

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Section: Discussionsupporting

confidence: 93%