5-year experience with metallic stents for chronic ureteral obstruction

Abstract

Purpose

Our objective was to present 5 years of outcome data for metallic ureteral stents in a cohort of patients treated for chronic ureteral obstruction.

Patients and Methods

All patients in whom a Resonance metallic stent (Cook Medical, Bloomington, IN) was deployed between early 2007 and late 2011 at our institution were retrospectively identified and analyzed. A descriptive analysis was performed for key outcomes of failure rate, death rate, and duration ofstenting (defined as time from initial stent placement to last stent failure or death of the patient). A secondary comparative analysis between patients with benign and malignant etiology of obstruction was performed.

Results

139 metallic stents were deployed in 47 patients; 27 patients (57%) had malignant and 20 (43%) had benign etiology; 15 patients (32%) had bilateral obstruction. Mean follow-up was 20 months (median 13, IQR 4-31, max 59 months). 13 patients experienced stent failure (28% of total, 4 in benign, 9 in malignant, p = 0.35). The median duration of stenting for benign and malignant obstruction was 22 (IQR 9-39) months versus 7 (IQR 3-25) months, respectively (p = 0.106). Duration of stenting was equivalent when controlling for a higher death rate in the malignant group.

Conclusions

Resonance metallic stents are an adequate management strategy for both benign and malignant ureteral obstruction, with a subset of patients in each group continuing to do well at over 3 years overall duration of stenting. Failure rates are similar for benign and malignant etiology.

http://www.jurology.com/article/S0022-5347(13)00345-5/abstract