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Published in: World Journal of Urology 3/2014

01-06-2014 | Original Article

Metallic ureteral stents in malignant ureteral obstruction: short-term results and radiological features predicting stent failure in patients with non-urological malignancies

Authors: Po-Ming Chow, Jui-Shan Hsu, Shuo-Meng Wang, Hong-Jheng Yu, Yeong-Shiau Pu, Kao-Lang Liu

Published in: World Journal of Urology | Issue 3/2014

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Abstract

Purpose

To provide short-term result of the metallic ureteral stent in patients with malignant ureteral obstruction and identify radiological findings predicting stent failure.

Materials and methods

The records of all patients with non-urological malignant diseases who have received metallic ureteral stents from July 2009 to March 2012 for ureteral obstruction were reviewed. Stent failure was detected by clinical symptoms and imaging studies. Survival analysis was used to estimate patency rates and factors predicting stent failure.

Results

A total of 74 patients with 130 attempts of stent insertion were included. A total of 113 (86.9 %) stents were inserted successfully and 103 (91.2 %) achieved primary patency. After excluding cases without sufficient imaging data, 94 stents were included in the survival analysis. The median functional duration of the 94 stents was 6.2 months (range 3–476 days). Obstruction in abdominal ureter (p = 0.0279) and lymphatic metastasis around ureter (p = 0.0398) were risk factors for stent failure. The median functional durations of the stents for abdominal and pelvic obstructions were 4.5 months (range 3–263 days) and 6.5 months (range 4–476 days), respectively. The median durations of the stents with and without lymphatic metastasis were 5.3 months (range 4–398 days) and 7.8 months (range 31–476 days), respectively.

Conclusion

Metallic ureteral stents are effective and safe in relieving ureteral obstructions resulting from non-urological malignancies, and abdominal ureteral obstruction and lymphatic metastasis around ureter were associated with shorter functional duration.
Literature
1.
go back to reference Docimo SG, Dewolf WC (1989) High failure rate of indwelling ureteral stents in patients with extrinsic obstruction: experience at 2 institutions. J Urol 142(2 Pt 1):277–279PubMed Docimo SG, Dewolf WC (1989) High failure rate of indwelling ureteral stents in patients with extrinsic obstruction: experience at 2 institutions. J Urol 142(2 Pt 1):277–279PubMed
2.
go back to reference Chung SY, Stein RJ, Landsittel D, Davies BJ, Cuellar DC, Hrebinko RL, Tarin T, Averch TD (2004) 15-year experience with the management of extrinsic ureteral obstruction with indwelling ureteral stents. J Urol 172(2):592–595PubMedCrossRef Chung SY, Stein RJ, Landsittel D, Davies BJ, Cuellar DC, Hrebinko RL, Tarin T, Averch TD (2004) 15-year experience with the management of extrinsic ureteral obstruction with indwelling ureteral stents. J Urol 172(2):592–595PubMedCrossRef
3.
go back to reference Russo P (2000) Urologic emergencies in the cancer patient. Semin Oncol 27(3):284–298PubMed Russo P (2000) Urologic emergencies in the cancer patient. Semin Oncol 27(3):284–298PubMed
4.
go back to reference Lugmayr H, Pauer W (1992) Self-expanding metal stents for palliative treatment of malignant ureteral obstruction. AJR Am J Roentgenol 159(5):1091–1094PubMedCrossRef Lugmayr H, Pauer W (1992) Self-expanding metal stents for palliative treatment of malignant ureteral obstruction. AJR Am J Roentgenol 159(5):1091–1094PubMedCrossRef
5.
go back to reference Liatsikos EN, Karnabatidis D, Katsanos K, Kallidonis P, Katsakiori P, Kagadis GC, Christeas N, Papathanassiou Z, Perimenis P, Siablis D (2009) Ureteral metal stents: 10-year experience with malignant ureteral obstruction treatment. J Urol 182(6):2613–2618. doi:10.1016/j.juro.2009.08.040 PubMedCrossRef Liatsikos EN, Karnabatidis D, Katsanos K, Kallidonis P, Katsakiori P, Kagadis GC, Christeas N, Papathanassiou Z, Perimenis P, Siablis D (2009) Ureteral metal stents: 10-year experience with malignant ureteral obstruction treatment. J Urol 182(6):2613–2618. doi:10.​1016/​j.​juro.​2009.​08.​040 PubMedCrossRef
7.
go back to reference Borin JF, Melamud O, Clayman RV (2006) Initial experience with full-length metal stent to relieve malignant ureteral obstruction. J Endourol 20(5):300–304PubMedCrossRef Borin JF, Melamud O, Clayman RV (2006) Initial experience with full-length metal stent to relieve malignant ureteral obstruction. J Endourol 20(5):300–304PubMedCrossRef
8.
go back to reference Wah TM, Irving HC, Cartledge J (2007) Initial experience with the resonance metallic stent for antegrade ureteric stenting. Cardiovasc Intervent Radiol 30(4):705–710PubMedCrossRef Wah TM, Irving HC, Cartledge J (2007) Initial experience with the resonance metallic stent for antegrade ureteric stenting. Cardiovasc Intervent Radiol 30(4):705–710PubMedCrossRef
10.
go back to reference Nagele U, Kuczyk MA, Horstmann M, Hennenlotter J, Sievert K-D, Schilling D, Walcher U, Stenzl A, Anastasiadis AG (2008) Initial clinical experience with full-length metal ureteral stents for obstructive ureteral stenosis. World J Urol 26(3):257–262. doi:10.1007/s00345-008-0245-4 PubMedCrossRef Nagele U, Kuczyk MA, Horstmann M, Hennenlotter J, Sievert K-D, Schilling D, Walcher U, Stenzl A, Anastasiadis AG (2008) Initial clinical experience with full-length metal ureteral stents for obstructive ureteral stenosis. World J Urol 26(3):257–262. doi:10.​1007/​s00345-008-0245-4 PubMedCrossRef
11.
go back to reference Liatsikos E, Kallidonis P, Kyriazis I, Constantinidis C, Hendlin K, Stolzenburg J-U, Karnabatidis D, Siablis D (2010) Ureteral obstruction: is the full metallic double-pigtail stent the way to go? Eur Urol 57(3):480–486PubMedCrossRef Liatsikos E, Kallidonis P, Kyriazis I, Constantinidis C, Hendlin K, Stolzenburg J-U, Karnabatidis D, Siablis D (2010) Ureteral obstruction: is the full metallic double-pigtail stent the way to go? Eur Urol 57(3):480–486PubMedCrossRef
14.
go back to reference Li CC, Li JR, Huang LH, Hung SW, Yang CK, Wang SS, Chen CS, Ou YC, Ho HC, Su CK, Chen WM, Cheng CL, Yang CR, Chiu KY (2011) Metallic stent in the treatment of ureteral obstruction: experience of single institute. J Chin Med Assoc 74(10):460–463. doi:10.1016/j.jcma.2011.08.017 PubMedCrossRef Li CC, Li JR, Huang LH, Hung SW, Yang CK, Wang SS, Chen CS, Ou YC, Ho HC, Su CK, Chen WM, Cheng CL, Yang CR, Chiu KY (2011) Metallic stent in the treatment of ureteral obstruction: experience of single institute. J Chin Med Assoc 74(10):460–463. doi:10.​1016/​j.​jcma.​2011.​08.​017 PubMedCrossRef
16.
go back to reference Garg T, Guralnick ML, Langenstroer P, See WA, Hieb RA, Rilling WS, Sudakoff GS, O’Connor RC (2009) Resonance metallic ureteral stents do not successfully treat ureteroenteric strictures. J Endourol 23(7):1199–1201 discussion 1202PubMedCrossRef Garg T, Guralnick ML, Langenstroer P, See WA, Hieb RA, Rilling WS, Sudakoff GS, O’Connor RC (2009) Resonance metallic ureteral stents do not successfully treat ureteroenteric strictures. J Endourol 23(7):1199–1201 discussion 1202PubMedCrossRef
17.
go back to reference Lopez-Huertas HL, Polcari AJ, Acosta-Miranda A, Turk TMT (2010) Metallic ureteral stents: a cost-effective method of managing benign upper tract obstruction. J Endourol 24(3):483–485PubMedCrossRef Lopez-Huertas HL, Polcari AJ, Acosta-Miranda A, Turk TMT (2010) Metallic ureteral stents: a cost-effective method of managing benign upper tract obstruction. J Endourol 24(3):483–485PubMedCrossRef
18.
go back to reference Modi AP, Ritch CR, Arend D, Walsh RM, Ordonez M, Landman J, Gupta M, Knudsen BE (2010) Multicenter experience with metallic ureteral stents for malignant and chronic benign ureteral obstruction. J Endourol 24(7):1189–1193. doi:10.1089/end.2010.0121 PubMedCrossRef Modi AP, Ritch CR, Arend D, Walsh RM, Ordonez M, Landman J, Gupta M, Knudsen BE (2010) Multicenter experience with metallic ureteral stents for malignant and chronic benign ureteral obstruction. J Endourol 24(7):1189–1193. doi:10.​1089/​end.​2010.​0121 PubMedCrossRef
19.
go back to reference Bechtold RB, Chen MY, Dyer RB, Zagoria RJ (1998) CT of the ureteral wall. AJR Am J Roentgenol 170(5):1283–1289PubMedCrossRef Bechtold RB, Chen MY, Dyer RB, Zagoria RJ (1998) CT of the ureteral wall. AJR Am J Roentgenol 170(5):1283–1289PubMedCrossRef
20.
go back to reference Liatsikos EN, Kagadis GC, Barbalias GA, Siablis D (2005) Ureteral metal stents: a tale or a tool? J Endourol 19(8):934–939PubMedCrossRef Liatsikos EN, Kagadis GC, Barbalias GA, Siablis D (2005) Ureteral metal stents: a tale or a tool? J Endourol 19(8):934–939PubMedCrossRef
21.
go back to reference Lloyd SN, Tirukonda P, Biyani CS, Wah TM, Irving HC (2007) The detour extra-anatomic stent—a permanent solution for benign and malignant ureteric obstruction? Eur Urol 52(1):193–198PubMedCrossRef Lloyd SN, Tirukonda P, Biyani CS, Wah TM, Irving HC (2007) The detour extra-anatomic stent—a permanent solution for benign and malignant ureteric obstruction? Eur Urol 52(1):193–198PubMedCrossRef
22.
go back to reference Aravantinos E, Anagnostou T, Karatzas AD, Papakonstantinou W, Samarinas M, Melekos MD (2007) Percutaneous nephrostomy in patients with tumors of advanced stage: treatment dilemmas and impact on clinical course and quality of life. J Endourol 21(11):1297–1302PubMedCrossRef Aravantinos E, Anagnostou T, Karatzas AD, Papakonstantinou W, Samarinas M, Melekos MD (2007) Percutaneous nephrostomy in patients with tumors of advanced stage: treatment dilemmas and impact on clinical course and quality of life. J Endourol 21(11):1297–1302PubMedCrossRef
23.
go back to reference Yossepowitch O, Lifshitz DA, Dekel Y, Gross M, Keidar DM, Neuman M, Livne PM, Baniel J (2001) Predicting the success of retrograde stenting for managing ureteral obstruction. J Urol 166(5):1746–1749PubMedCrossRef Yossepowitch O, Lifshitz DA, Dekel Y, Gross M, Keidar DM, Neuman M, Livne PM, Baniel J (2001) Predicting the success of retrograde stenting for managing ureteral obstruction. J Urol 166(5):1746–1749PubMedCrossRef
Metadata
Title
Metallic ureteral stents in malignant ureteral obstruction: short-term results and radiological features predicting stent failure in patients with non-urological malignancies
Authors
Po-Ming Chow
Jui-Shan Hsu
Shuo-Meng Wang
Hong-Jheng Yu
Yeong-Shiau Pu
Kao-Lang Liu
Publication date
01-06-2014
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 3/2014
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-013-1143-y

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