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Externally coated ureteral metallic stents: an unfavorable clinical experience
George A Barbalias1, Evangelos N Liatsikos, Christina Kalogeropoulou
1Department of Urology, University of Patras Medical School, University Hospital, Rio, 26 500, Patras, Greece. gbarbal@med.upatras.gr
Objective:
The purpose of the present study was to evaluate the use of externally coated stents in patients with malignant ureteral obstruction.
Materials And Methods:
We have prospectively evaluated 16 patients, 10 men and 6 women, with malignant ureteral obstruction treated successfully by placement of Passager metal stents (Boston Scientific, Natick, MA, USA) bypassing the stricture. Mean patient age was 65.6 years (range 62-78 years). Ureteral patency was confirmed 24 and 48 hours by injection of contrast material through the nephrostomy tube, and after patency confirmation the nephrostomy catheter was removed.
Results:
All stents were positioned successfully, and the postoperative course was uneventful. In 13 cases (81.2%) the prostheses finally migrated into the bladder hindering overall ureteral patency (mean time of migration: 1.5 months). Patency was achieved in the remaining ureters (n=3), during the follow-up period (mean: 8 months, range 6-16 months), without any need for further intervention.
Conclusion:
The inappropriate anchorage and the increased ureteral peristalsis are the main causes of migration towards the bladder, thus, minimizing the usefulness of this stent for the treatment of ureteral strictures.