An alternative approach to stenting the obstructed ureter

Abstract

Ureteric stenting allows palliative treatment of strictures resulting from trauma, surgery, neoplasm or from scarring following treatment of malignancy. Retrograde and antegrade approaches can be used (Mitty et al, 1986; Shore et al, 1987) but, in a small proportion of patients, neither approach is successful, and patients with ureters which are completely occluded present a problem. We describe a combined antegrade and retrograde technique analogous to that used in biliary stenting (Robertson et al, 1987; Freeman et al, 1991) as a useful method in such cases. Three cases are described which illustrate the salient features. A 56-year-old man was admitted for insertion of a stent across an obstructed right distal ureteric orifice. His well-differentiated bladder tumour had been treated by several endoscopic resections over the previous 5 years and one course of intravesical chemotherapy had been given 16 months earlier.