Ureteral Obstruction: Is the Full Metallic Double-Pigtail Stent the Way to Go?

Liatsikos, Evangelos; Kallidonis, Panagiotis; Kyriazis, Iason; Constantinidis, C.; Hendlin, Kari; Stolzenburg, Jens‐Uwe; Karnabatidis, Dimitrios; Siablis, Dimitrios

doi:10.1016/j.eururo.2009.02.004

Cited by 103 publications

(82 citation statements)

References 18 publications

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“…followup at our center, the sample size of our series was small and underpowered for multivariate modeling. However, this series of 37 stents is similar in size to most series recently published on this device, 11,12,14,15 and the first to focus exclusively on MUO. In addition, it would be interesting to assess the impact of the metallic stent on health related quality of life in patients with MUO in a prospective trial setting.…”

Section: Discussionmentioning

confidence: 69%

“…[11][12][13][14][15] Overall failure rates in cohorts including MUO and nonMUO cases have ranged widely from 7% to 66%. [11][12][13][14][15] Of note, although no prior studies have focused exclusively on patients with MUO, this subset of patients was found to have higher failure rates in 3 previous series. 11,14,15 Other series have demonstrated equivalent 13 or even improved outcomes 12 in patients with MUO.…”

Section: Discussionmentioning

confidence: 99%

“…For this analysis our definition of failure was similar to comparable studies, [11][12][13][14][15] as unplanned stent exchange or nephrostomy tube placement for signs or symptoms of recurrent ureteral obstruction (recurrent hydroureteronephrosis or increasing creatinine). In applying this standard to our cohort of 37 stents placed for MUO, a failure rate of 35% was identified.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of Metallic Stents for Malignant Ureteral Obstruction

et al. 2012

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Purpose: Malignant ureteral obstruction often necessitates chronic urinary diversion and is associated with high rates of failure with traditional ureteral stents. We evaluated the outcomes of a metallic stent placed for malignant ureteral obstruction and determined the impact of risk factors previously associated with increased failure rates of traditional stents. Materials and Methods: Patients undergoing placement of the metallic Resonance® stent for malignant ureteral obstruction at an academic referral center were identified retrospectively. Stent failure was defined as unplanned stent exchange or nephrostomy tube placement for signs or symptoms of recurrent ureteral obstruction (recurrent hydroureteronephrosis or increasing creatinine). Predictors of time to stent failure were assessed using Cox regression. Results: A total of 37 stents were placed in 25 patients with malignant ureteral obstruction. Of these stents 12 (35%) were identified to fail. Progressive hydroureteronephrosis and increasing creatinine were the most common signs of stent failure. Three failed stents had migrated distally and no stents required removal for recurrent infection. Patients with evidence of prostate cancer invading the bladder at stent placement were found to have a significantly increased risk of failure (HR 6.50, 95% CI 1.45-29.20, p ϭ 0.015). Notably symptomatic subcapsular hematomas were identified in 3 patients after metallic stent placement. Conclusions: Failure rates with a metallic stent are similar to those historically observed with traditional polyurethane based stents in malignant ureteral obstruction. The invasion of prostate cancer in the bladder significantly increases the risk of failure. Patients should be counseled and observed for subcapsular hematoma formation with this device.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Outcomes of Metallic Stents for Malignant Ureteral Obstruction

et al. 2012

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“…1,2 The ResonanceÒ metallic stent (Cook Medical, Bloomington, IN, USA) has been introduced with a high success rate in the treatment of malignant extrinsic compression other than benign intrinsic stenosis. 11,12 It is lumenless and solid, with a spiral design so that it can withstand strong external compression forces and allow urine passage from its grooves. The nickelechromiumecobalt metal composition also has a low stone encrustation rate, resulting in a long period of maintenance.…”

Section: Introductionmentioning

confidence: 99%

Metallic stent in the treatment of ureteral obstruction: Experience of single institute

Huang

et al. 2011

Journal of the Chinese Medical Association

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“…Liatsikos et al [49] recently evaluated the mid-term effectiveness (8.5 months of follow-up) of the Resonance stent used in 25 patients with MUO. The technical success rate was 100% and all stents remained patent during the follow-up.…”

Section: Experience With the Resonance Stentmentioning

confidence: 99%

Current status of metal stents for managing malignant ureteric obstruction

et al. 2010

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Obstruction of the ureters caused by extrinsic compression from a primary tumour or retroperitoneal lymph node masses is not unusual in the course of advanced pelvic malignancies. Most of the cases are of gynaecological or gastrointestinal origin, and the situation can be aggravated by peri‐ureteric fibrosis, a long‐term adverse event of previous chemotherapy or radiotherapy. Undoubtedly upper urinary tract decompression and maintenance of ureteric patency, even as a palliative measure, is important in managing these patients. Options for upper tract decompression include percutaneous nephrostomy, retrograde stenting and open urinary diversion. Plastic stents have long been used for managing malignant ureteric obstruction, but their overall success remains limited. Plastic stents often fail to be placed correctly, require regular exchange, and are faced with a high incidence of encrustation and migration. For these reasons plastic stents have been unsuccessful for long‐term maintenance of ureteric patency. To overcome these limitations metal stents were introduced and recently developed in an effort to ensure better long‐term patency of the obstructed ureter, fewer hospital admissions for stent change and better overall quality of life. In the present review the clinical applications of different types of metal stents are discussed, with a specific focus on the latest advances and the future options for managing malignant ureteric obstruction.

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Ureteral Obstruction: Is the Full Metallic Double-Pigtail Stent the Way to Go?

Cited by 103 publications

References 18 publications

Outcomes of Metallic Stents for Malignant Ureteral Obstruction

Outcomes of Metallic Stents for Malignant Ureteral Obstruction

Metallic stent in the treatment of ureteral obstruction: Experience of single institute

Current status of metal stents for managing malignant ureteric obstruction

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