Abstract
BackgroundRefractory non-malignant ureterostenosis is challenging to treat. The experience to treat the stenosis primarily cause by retroperitoneal fibrosis with the Resonance and Allium metallic stent is still limited. We aim to evaluate the efficacy and safety of these two stents and provide alternative treatment options.MethodsA retrospective study was conducted for patients with non-malignant ureterostenosis and treated with the Resonance and Allium stents from March 2011 to September 2020 in our department. The efficacy was evaluated by the change of serum creatinine, glomerular filtration rate (GFR), the proportion of GFR of the affected side and hydronephrosis grade. The safety was evaluated by postoperative presence of moderate or severe overactive bladder (OAB), recurrent urinary infection, pain, stent displacement, encrustation and re-obstruction.Results33 patients were eligible for the study, including 18 cases treated by the Resonance stents and 15 patients treated by the Allium stents. The patients of two groups had similar age and gender proportion. The cause of ureterostenosis was mainly retroperitoneal fibrosis in both groups but the Resonance group had more idiopathic cases. Follow-up time was significantly longer in the Resonance group than the Allium group (36.2 ± 24.0 vs 9.4 ± 5.0 months, p < 0.001). Both groups showed improvement or maintenance of serum creatinine level, GFR, the GFR proportion of the affected side and hydronephrosis grade after treatment. The Resonance group presented significant higher incidence of moderate or severe OAB, recurrent urinary infection and pain, while the Allium group showed significant more cases of re-obstruction.ConclusionBoth the Resonance and Allium stent can relieve the non-malignant refractory ureterostenosis effectively. The Resonance stent may cause more irritable symptoms while the Allium stent may have a higher rate of re-obstruction. The long term efficacy and safety of the Allium stent in treating non-malignant refractory ureterostenosis requires further study.
Highlights
A ureteral stent can drain the upper urinary tract and preserve kidney function, thereby providing time for further treatment and improving the patient’s qualityGao et al BMC Urol (2021) 21:53 malignancies [1]
Study design A retrospective study was conducted in patients with non-malignant cause of ureterostenosis treated by Resonance or Allium stent from March 2011 to September 2020 at Department of Urology, Xuanwu Hospital, Capital Medical University, Beijing, PR China
Since radiotherapy in the corresponding area may cause urethral stricture in patients with history of malignancy, and the stricture is caused by secondary retroperitoneal fibrosis (SRPF) secondary to radiation but not the malignancy itself, these patients were included in the study if they have no evidence of tumor recurrence
Summary
A ureteral stent can drain the upper urinary tract and preserve kidney function, thereby providing time for further treatment and improving the patient’s qualityGao et al BMC Urol (2021) 21:53 malignancies [1]. It is resistant to extrinsic compression and occlusion These properties allow longer dwelling time and less frequent stent exchanges. This stent provided a long-term renal protective effect and might be more costeffective [2]. The metal component provides radial and longitudinal strength, while the polymer bio-inertness prevents tissue ingrowth into the lumen and early encrustation. Both two stents have shown good efficacy in treating malignant ureteral strictures [3, 4]. The experience to treat the stenosis primarily cause by retroperitoneal fibrosis with the Resonance and Allium metallic stent is still limited. We aim to evaluate the efficacy and safety of these two stents and provide alternative treatment options
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