Metallic stents for malignant and benign ureteric obstruction

To report our experience of using metallic stents to treat ureteric obstruction caused by malignant or benign disease.

Nine patients with obstruction in 11 ureters caused by malignant or benign disease (mean age 61 years, range 35-82, mean follow-up 7 months, range 3-11) were treated using metallic stents. A balloon-expandable metallic stent was used in one patient and self-expandable metallic stents in the remaining eight. All stents were inserted via a percutaneous antegrade approach.

Of the 11 ureters, nine remained patent with no further manipulation during the follow-up of 3-11 months. An additional stent was placed in continuity with the first in two ureters of two patients at 4 and 5 weeks after the first procedure because of persistent obstruction. After the second intervention, their obstruction was improved. Transient vesico-ureteric reflux occurred in two of three stented distal ureters, but the reflux resolved spontaneously within 2 months after stent implantation. Ureteric patency was maintained in all patients and no major complications related to stenting occurred during the follow-up. Two patients died from cervical cancer at 3 and 5 months after stenting.

In patients with difficult ureteric obstructions a metallic stent provides a safe and effective alternative to an indwelling double-pigtail catheter or percutaneous nephrostomy.