Metal Ureteral Stent for Benign and Malignant Ureteral Obstruction

Abstract

Metal ureteral stents are a relatively new version of a device with a long history of relieving ureteral obstruction. Metal stents are effective for relieving ureteral obstruction but success regarding patient tolerability has been variable. We present our single institution experience with long-term metal ureteral stent placement. The charts of patients undergoing metal ureteral stent placement for chronic ureteral obstruction were reviewed. Data collected included patient age, gender, diagnosis/cause of obstruction, laterality, duration of indwelling metal stent, number of routine metal stent changes, complications and early discontinuations or stent changes. A total of 23 patients underwent placement of metal ureteral stents between February 2008 and September 2010. Bilateral stents were placed in 5 patients and 9 underwent a yearly metal stent exchange for a total of 42 ureteral units treated with metal ureteral stents. All metal stents were placed to relieve ureteral obstruction due to ureteral stricture, ureteropelvic junction obstruction, retroperitoneal fibrosis or extrinsic malignant obstruction. There were 3 metal stent failures in 2 patients with malignant ureteral obstruction. There were no complications, or early discontinuations or changes due to adverse symptoms, patient dissatisfaction, worsening renal function or progressive hydronephrosis. Metal ureteral stents are effective for benign and malignant ureteral obstruction in the absence of urolithiasis. Good tolerability and annual stent exchange make metal stents an appealing alternative for patients with chronic ureteral obstruction treated with indwelling ureteral stents.