The detour extra-anatomic stent--a permanent solution for benign and malignant ureteric obstruction?

Area of Science:

• Urology
• Medical Devices
• Surgical Innovation

Background:

• Complete upper urinary tract obstruction presents significant management challenges.
• Conventional stenting and open surgery are not always feasible or successful.
• Long-term nephrostomy drainage is often undesirable for patients.

Observation:

• The Detour extra-anatomic stent (EAS) was used in eight patients (nine insertions) between 2002 and 2005.
• Indications included malignant disease (3 patients) and complicated benign disease (5 patients).
• The stent is a self-retaining, expanded polytetrafluoroethylene-silicone tube placed percutaneously and tunneled to the bladder.

Findings:

• Four of five patients with benign disease survived, with no stent-related complications reported besides infection and hematuria.
• Two patients with malignant disease died but experienced no urinary drainage issues in their final years.
• The Detour EAS facilitated internal urinary drainage, bypassing ureteric obstructions effectively.

Implications:

• The Detour EAS shows promise as a permanent, minimally invasive option for complex ureteric obstructions.
• This technique offers an alternative when standard treatments have failed or are not viable.
• Further research may validate the long-term efficacy and safety of the Detour EAS.