A 6-year retrospective cost-effectiveness analysis of Memokath ureteric stents vs double-J stents - single-centre...

Double-J (JJ) stents are widely used in obstructive uropathy but are associated with encrustation, infection, migration, and the need for repeated exchanges. Metallic ureteric stents such as the Memokath-051 (MMK), in use since 1996, demonstrate high patency rates and efficacy in both benign and malignant ureteric strictures. While prior studies suggest cost-effectiveness over JJ stents, UK-specific data remain limited. This study evaluates the cost-effectiveness, function, and safety of MMK in chronic obstructive uropathy.

A retrospective cohort study was conducted of adult patients who underwent MMK insertion between March 2016 and August 2022 for malignant or benign ureteric strictures. Patients with pregnancy, acute sepsis, or acute renal failure were excluded. The primary outcome was cost-effectiveness compared with JJ stent exchanges. Secondary outcomes were stent function and safety.

Twenty-one patients (10 men, 11 women) were included, with a median age of 69 years (range:46-86). Left ureteric stents accounted for 38%, right ureteric in 52%, and bilaterally in 10%. 81% benign obstruction, with the remaining malignant. Stent lengths ranged from 6-15 cm.After a follow-up of up to 65 months, 52% of patients retained their MMK stent in situ. 20% required removal due to encrustation or haematuria, and 10% experienced spontaneous stent migration. Overall, 70% were successfully managed with MMK. 20% died with the stent in situ (mean duration:15 months). 18% retained stents for >6 months (median: 25 months).Total cost savings were £42,890 compared with repeated JJ stent exchanges, increasing proportionally with stent dwell time. No MMK-related infections or infection-related admissions occurred.

Memokath-051 is a safe and cost-effective option for chronic obstructive uropathy, with a clinical success rate of 72% and substantial cost savings, particularly in benign strictures. Patients with malignant obstruction may benefit clinically, though shorter stent duration reduces cost-effectiveness.