Metallic stent in the treatment of ureteral obstruction: experience of single institute.

BACKGROUND: The Resonance(®) metallic stent has been reported to be sufficient for the management of malignant extrinsic ureteral obstructions within a 12-month time period. To determine the effectiveness in each specific patient group, we report our experience using the Resonance(®) stent in the treatment of ureteral obstructions.

METHODS: We retrospectively reviewed 20 patients (23 stents) who successfully received the Resonance(®) metallic stents and divided them into a patent group (n = 19) and an obstructive group (n = 4) according to the treatment results. Twenty-one stents were inserted via cystoscopy or ureteroscopy in a retrograde fashion. The remaining two were inserted via percutaneous nephrostomy in an antegrade manner. Follow-up serum creatinine measurements and sonography were performed. The overall ureteral patency rate and the risk of stent failure were evaluated.

RESULTS: The overall ureteral patency rate was 82.6% (19/23). Patients with previous radiotherapy had a 50% (4/8) patency rate which was significantly lower than non-radiotherapy patients (100%, 15/15, p = 0.028). Malignant obstructions in those other than radiotherapy patients had a 100% patency rate (5/5). Benign obstructions in those other than radiotherapy patients had a 100% patency rate (10/10). In the radiotherapy patients, the mode of therapy did not dominate the stent outcome.

CONCLUSION: Patients with ureteral obstructions can be treated sufficiently with the Resonance(®) metallic stent. Patients who had gynecological malignancies and received radiotherapy had a higher failure rate after Resonance(®) metallic stent insertion.