A New Customized Ureteral Stent with Nonrefluxing Silicone End-piece to Alleviate Stent-related Symptoms in Malignant Diseases

Abstract

To evaluate the stent-related symptoms using a new customized ureteral stent with a nonrefluxing silicone end-piece. By decreasing the amount of material within the bladder, it should be possible to attenuate the stent-related symptoms. To minimize the amount of material, 17 consecutive patients already fitted with a double-pigtail stent for malignant ureteral obstruction agreed to be fitted with a customized stent where the bladder loop was replaced by a nonrefluxing silicone end-piece. The ureteral stent symptom questionnaire was prospectively administered to patients at baseline with double-pigtail stent and Day 15 after customized stent placement. No difficulty in the placement of the customized stent was encountered. No stent failure, no dislodgment and no calcification were observed 6 months after stenting. The scores for the main domain "Urinary symptoms" (34.4 ± 3.6 vs 23.0 ± 7.0; P=.0004) and the question "Global quality of life" (4.4 ± 2.0 vs 2.4 ± 2.1; P=.01) were significantly decreased by the replacement of the double-pigtail stent by the customized stent. The customized ureteral stent may constitute an improvement in the field of stent-related symptoms and seems fit for use in its current shape. Studies exploring and exploiting new concepts are greatly required to reduce stent-related symptoms in all patients including those with cancer.