Role of ureteric stents in relieving obstruction in patients with obstructive uropathy

Abstract

Purpose:The aim of this study is to evaluate the role of ureteric stents in relieving obstruction and improvement of kidney function in patients with obstructive uropathy.Materials and Methods:This study involved 138 patients with obstructive uropathy with age ranged from 2 months to 73 years. Patients classified into two groups: Group (I): Includes 57 patients (41.3%), ureteric stents fixed to them; and Group (II): Includes 81 patients (58.6%) managed by other treatment modalities. All patients underwent clinical assessment, Laboratory and radiologic investigations: At presentation and postoperative. These included: Complete urine analysis, urine culture and sensitivity, serum creatinine, serum urea nitrogen, serum uric acid, serum sodium (Na), serum potassium (K), Fasting blood glucose level and blood picture and plain X-ray (KUB), abdominal ultrasonography (US), diuretic renography and retrograde pyelography.Results:Renal glomerular filtration rate (GFR) was used as an indicator for improvement of renal function after fixation of ureteric stent. In group I: 56 (71.8%) kidneys showed significant recovery compared to 61 kidneys (66.3%). In group II, there is statistically significant relation between renal perfusion and renal recovery (P < 0.004), statistically significant relation between parenchymal thickness and recovery in both groups (P < 0.0002), statistically significant relation between degree of corticomedullary differentiation and recovery (P < 0.0003) and statistically significant relationship between hemoglobin levels at presentation and the recoverability (P < 0.002).Conclusion:The predictors of renal recoverability revealed that ureteral stents alone can help in regaining renal function and significant improvement of clinical condition in patients with obstructive uropathy.

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“…In addition to the above two, few also believe in stenting the un-operated renal unit to prevent any further functional deterioration during the waiting time [ 7 ]. In complicated cases presenting as urosepsis or large mass causing respiratory distress, temporizing procedures such as percutaneous nephrostomy (PCN) and cystoscopy may be required for relieving the obstruction [ 7 , 9 ]. Shehab et al have demonstrated significant improvement in the renal function and clinical condition of the patients with obstructive uropathy following ureteral stenting [ 9 ].…”

“…In complicated cases presenting as urosepsis or large mass causing respiratory distress, temporizing procedures such as percutaneous nephrostomy (PCN) and cystoscopy may be required for relieving the obstruction [ 7 , 9 ]. Shehab et al have demonstrated significant improvement in the renal function and clinical condition of the patients with obstructive uropathy following ureteral stenting [ 9 ]. In the index case (case no 2), retrograde stenting was not successful on the more severely obstructed side.…”