Silicone double-j stents for long-term ureteral stenting: results from a multicentric PEARLS analysis

To analyze outcomes from long-term ureteral stenting using silicone double-j stents (maximal dwell time of 12 months).

Patients undergoing first-time insertion of an ImaJin™ or ImaJin Hydro™ silicone double-j stent with a planned dwell time of a least 3 months were considered. Patients treated between 2018 and 2024 were included in this multicenter, retrospective study. Primary endpoint was stent failure, defined as unplanned premature re-intervention.

105 patients were available for analysis. Median age was 63 years. All stents were inserted using a hydrophilic guidewire without any complications related to stent insertion. In 11 patients (10%) the cause of ureteral obstruction was extrinsic, in 31 patients (30%) parietal and in 63 patients (60%) intra-luminal. Stent failure-free survival estimates at 1,3,6,9 and 12 months were 99%,98%,88%,82% and 69%, respectively. Estimated mean failure-free survival was 307 days (95% confidence interval 282 to 332). Among all baseline and perioperative parameters, increasing patient weight, increasing urinary leucocytes, and urinary tract infection (UTI) were found to be significant and independent predictors of stent failure (all p < 0.05). Spontaneous stent migration was noted in one patient (< 1%). Stent encrustation was documented in 13 patients (12%), with five of these cases occurring after > 365 days.

Long-term ureteral stenting with silicone double-j stents seems to be an effective and safe treatment with low encrustation and stent migration rates. Close follow-up and screening for stent failure shall be considered in patients with high weight, high urinary leucocytes or in cases with suspected UTI.