Auto-Expandable Metallic Ureteral Stents for Complex Ureteral Stenosis: Long-Term Outcomes in a Tertiary Institution

Auto-expandable ureteral stents can be an alternative to percutaneous nephrostomy (PCN) in refractory ureteral stenosis. Our aim was to analyse results and complications of ureteral stents in our centre.

Retrospective review of OptiMed® expandable ureteral stents placed in our centre (1996-2022). Analysis of complications (Clavien-Dindo classification) was performed. Kaplan-Meier curves (long-rank test) to assess stent permeability and Cox regression for associated factors were performed.

Fifty-eight patients were included. Median follow-up was 36 months (11-82). Median age was 61 years (48-68). Most frequent aetiology of ureteral stenosis was malignancy in 30 cases (53.6%). The most common location of stricture was distal ureter in 44 (63.8%) ureteral strictures. Creatinine levels improved in 28 (48.3%) cases. Most common acute complication was urinary tract infection in 6 (3.4%) patients (Clavien-Dindo II). Twenty patients presented with stent obstruction. Fourteen (24.1%) were solved with double J stenting and 6 (10.3%) cases with PCN. Mean stent survival time was 50 months (34.3-65.8). By the end of follow-up, 23 (39.6%) patients were alive. Of those, 9 (39.1%) had a functioning stent. No association of any factor with patency of stent was found.

Expandable ureteral stents are an alternative to PCN in fragile patients with refractory stenosis, which offers a better quality of life.