Extra-Anatomical Stents in Benign Ureteric Obstruction: Experience and Outcomes.

Abstract

Objectives: To present our experience with the Paterson-Forrester extra-anatomical stent (EAS; Cook Medical) in patients with benign ureteric obstruction. Utilizing an EAS in complex ureteric obstruction can have a significant positive impact on the quality of life as a result of removing external drainage devices. Materials and Methods: Between November 2012 and January 2021, 10 patients underwent 33 EAS procedures. All patients had benign ureteric obstruction. The mean age at primary procedure was 58 years (range 43-63). The median follow-up was 27.5 months (range 11-100). Informed consent was obtained from the patient(s) for the anonymized information to be published in this article. Results: Eight patients were successfully managed with EAS, with six patients continuing to have routine EAS exchanges. Two patients had the distal end exteriorized due to refractory bladder symptoms. There were three short-term failures; the distal end migrated out of the bladder requiring reinsertion 1 week later; one patient developed urosepsis requiring intravenous antibiotics and the stent removing within 30 days; one proximal stent migrated resulting in cutaneous erosion. The patient is now awaiting further EAS insertion. Conclusion: The Paterson-Forrester EAS is another tool in the endourologists' armamentarium when managing complex ureteric obstruction. In appropriately selected patients, it can improve their quality of life and is a durable long-term strategy in benign obstruction.