Risk factors in the prediction of long‐term patency of Resonance metallic ureteric stent in malignant ureteric obstruction

Ho, Brian; Chiu, Peter Ka‐Fung; Lam, Wayne; Wong, John; Wong, Charles; Lai, Terence Chun-ting; Tsang, Chi‐Ching; Ng, Anthony Chin-Ki; Chan, Connie; Ma, Wai‐Kit; Ng, Chi‐Fai; Tsu, James Hok‐Leung

doi:10.1002/bco2.14

Cited by 5 publications

(2 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…8 Finally, Ho et al noted that female sex and involvement of the ureteral orifice are poor prognostic factors, leading to obstruction of the Resonance stent in five months. 11 In addition, the use of this type of stent did not appear to be optimal for this patient.…”

Section: Stent Obstructionmentioning

confidence: 88%

It is Possible to Reduce Ureteral Stent Clogging and Stent-Related Symptoms to Soothe the Pain of the Patient: A Case Report

Vogt¹,

Dove-Rumé²

2023

RRU

View full text Add to dashboard Cite

Introduction Ureteral stent obstruction hinders the management of malignant diseases. Adequate stent insertion through an obstructed ureter does not necessarily guarantee renal decompression and stent-related symptoms adversely affect patient comfort. There are two major problems associated with ureteral stents: obstruction and intolerance to the stents. Case Presentation A 45-year-old woman was treated for cervical cancer with metastatic lymph nodes and ureteral obstruction with chemotherapy, radiotherapy, immunotherapy, and bilateral retrograde stenting. After recurrent stent obstruction, stent replacement was attempted more than 18 times over two years. In addition, stent-related symptoms adversely affected patient comfort. The patient was finally fitted with Superglide 8-French reinforced ureteral stents. Their replacement every six months was viewed by the patient as a relief compared to the all too frequent replacement of the previous stents. Moreover, the customized changes in the shape of Superglide stents improved patient comfort. Discussion Recent publications tend to indicate that large-lumen ureteral stents are most likely to remain permeable over time. Various modifications of the bladder or endo-ureteral part of double-pigtail stents have been increasingly reported, with the aim of improving their tolerance while maintaining effective drainage. Conclusion Adaptation of the internal lumen and shape of stents to the characteristics of the tumor and patient measurements appears to be important for increasing the drainage and tolerance of ureteral stents. The top priority for future ureteral stents suitable for malignant diseases should be to integrate these characteristics based on state-of-the-art data.

show abstract

Section: Stent Obstructionmentioning

confidence: 88%

It is Possible to Reduce Ureteral Stent Clogging and Stent-Related Symptoms to Soothe the Pain of the Patient: A Case Report

Vogt¹,

Dove-Rumé²

2023

RRU

View full text Add to dashboard Cite

show abstract

“… 10 , 16 , 17 , 18 In line with previous economic analyses by NICE, the infection rate with JJ was assumed to be the same as with Resonance. 8 Death was modelled based on the total pooled incidence of death in patient months, 10 , 16 , 17 , 18 , 19 , 20 , 21 , 22 used in addition to life UK life tables, weighted according to gender, and averaged over 5 years from age 57–62. Detailed calculation of transition probabilities can be found in Appendix S3 .…”

Section: Methodsmentioning

confidence: 99%

Cost‐effectiveness of Resonance® metallic ureteral stent compared with standard polyurethane ureteral stents in malignant ureteric obstruction: A cost‐utility analysis

Cooper,

Lines,

Shergill

2024

BJUI Compass

View full text Add to dashboard Cite

BackgroundMalignant ureteral obstruction (MUO) is a frequent challenge for urologists. Patients have poor prognoses, treatment aims to improve quality‐of‐life while optimising renal function. Standard practice in the United Kingdom is to use polyurethane stents, which require frequent surgical replacements for blockages and encrustation. More durable metallic stents are available, although these incur an increased initial purchase price.AimsWe aim to assess whether the use of polyurethane double‐J (JJ) or metallic stent, Resonance® is more cost‐effective for managing MUO in the UK healthcare setting.MethodsA Markov model was parameterised to 5 years with costs and health‐related quality‐of‐life consequences for treating MUO with Resonance metallic stent (Cook Medical), versus standard JJ stents, from the UK care system perspective, with 3.5% discounting. Deterministic and probabilistic sensitivity analyses were undertaken to assess the effect of uncertainty.ResultsOver 5 years, approximately four fewer repeat surgical interventions were estimated in the metallic stent arm compared with the JJ stent, driving a 23.4% reduction in costs. The mean estimates of costs and benefits indicate that treatment of MUO with Resonance for 5 years is dominant over JJ stents. Over 5 years a cost‐saving of £2164.74 and a health gain of +0.046 quality‐adjusted life years (QALYs) per patient is estimated. With a maximum willingness to pay of £20 k per QALY, a net monetary benefit (NMB) of £3077.83 is estimated. Probabilistic sensitivity analysis at a willingness to pay threshold of £20 000 indicates an 89.3% probability of Resonance being cost‐effective over JJ stents. Within 1‐year savings of £726.53 are estimated driven by a reduction of two fewer repeat surgical interventions when using the metallic stent.ConclusionsResonance metallic stents for the treatment of MUO reduce the number of repeat procedures and could be a cost‐effective option for the treatment, potentially offering efficiencies to the healthcare system.

show abstract