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Published in: BMC Urology 1/2021

Open Access 01-12-2021 | Overactive Bladder | Research article

The Resonance and the Allium ureteral stents in the treatment of non-malignant refractory ureterostenosis

Authors: Wei Gao, Tianying Xing, Tongwen Ou

Published in: BMC Urology | Issue 1/2021

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Abstract

Background

Refractory non-malignant ureterostenosis is challenging to treat. The experience to treat the stenosis primarily cause by retroperitoneal fibrosis with the Resonance and Allium metallic stent is still limited. We aim to evaluate the efficacy and safety of these two stents and provide alternative treatment options.

Methods

A retrospective study was conducted for patients with non-malignant ureterostenosis and treated with the Resonance and Allium stents from March 2011 to September 2020 in our department. The efficacy was evaluated by the change of serum creatinine, glomerular filtration rate (GFR), the proportion of GFR of the affected side and hydronephrosis grade. The safety was evaluated by postoperative presence of moderate or severe overactive bladder (OAB), recurrent urinary infection, pain, stent displacement, encrustation and re-obstruction.

Results

33 patients were eligible for the study, including 18 cases treated by the Resonance stents and 15 patients treated by the Allium stents. The patients of two groups had similar age and gender proportion. The cause of ureterostenosis was mainly retroperitoneal fibrosis in both groups but the Resonance group had more idiopathic cases. Follow-up time was significantly longer in the Resonance group than the Allium group (36.2 ± 24.0 vs 9.4 ± 5.0 months, p < 0.001). Both groups showed improvement or maintenance of serum creatinine level, GFR, the GFR proportion of the affected side and hydronephrosis grade after treatment. The Resonance group presented significant higher incidence of moderate or severe OAB, recurrent urinary infection and pain, while the Allium group showed significant more cases of re-obstruction.

Conclusion

Both the Resonance and Allium stent can relieve the non-malignant refractory ureterostenosis effectively. The Resonance stent may cause more irritable symptoms while the Allium stent may have a higher rate of re-obstruction. The long term efficacy and safety of the Allium stent in treating non-malignant refractory ureterostenosis requires further study.
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Literature
1.
go back to reference Christman MS, L’esperance JO, Choe CH, Stroup SP, Auge BK. Analysis of ureteral stent compression force and its role in malignant obstruction. J Urol. 2009;181(1):392–6.CrossRef Christman MS, L’esperance JO, Choe CH, Stroup SP, Auge BK. Analysis of ureteral stent compression force and its role in malignant obstruction. J Urol. 2009;181(1):392–6.CrossRef
2.
go back to reference Blaschko SD, Deane LA, Alfred Krebs BSF, et al. In-vivo evaluation of flow characteristics of novel metal ureteral stent. J Endourol. 2007;21:780–4.CrossRef Blaschko SD, Deane LA, Alfred Krebs BSF, et al. In-vivo evaluation of flow characteristics of novel metal ureteral stent. J Endourol. 2007;21:780–4.CrossRef
3.
go back to reference Christman MS, L’esperance JO, Choe CH, et al. Analysis of ureteral stent compression force and its role in malignant obstruction. J Urol. 2009;181:392–6.CrossRef Christman MS, L’esperance JO, Choe CH, et al. Analysis of ureteral stent compression force and its role in malignant obstruction. J Urol. 2009;181:392–6.CrossRef
4.
go back to reference Oderda M, Lacquaniti S, Fasolis G. Allium stent for the treatment of a malignant ureteral stenosis: a paradigmatic case. Urologia. 2018;85(2):87–90.CrossRef Oderda M, Lacquaniti S, Fasolis G. Allium stent for the treatment of a malignant ureteral stenosis: a paradigmatic case. Urologia. 2018;85(2):87–90.CrossRef
5.
go back to reference Duchene DA, Winfield HN, Cadeddu JA, Clayman RV, Gomella LG, Kavoussi LR, Mikhail AA, Park S, Permpongkosol S, Shalhav AL. Multi-institutional survey of laparoscopic ureterolysis for retroperitoneal fibrosis. Urology. 2007;69(6):1017–21.CrossRef Duchene DA, Winfield HN, Cadeddu JA, Clayman RV, Gomella LG, Kavoussi LR, Mikhail AA, Park S, Permpongkosol S, Shalhav AL. Multi-institutional survey of laparoscopic ureterolysis for retroperitoneal fibrosis. Urology. 2007;69(6):1017–21.CrossRef
6.
go back to reference Stifelman MD, Shah O, Mufarrij P, Lipkin M. Minimally invasive management of retroperitoneal fibrosis. Urology. 2008;71(2):201–4.CrossRef Stifelman MD, Shah O, Mufarrij P, Lipkin M. Minimally invasive management of retroperitoneal fibrosis. Urology. 2008;71(2):201–4.CrossRef
7.
go back to reference Liatsikos E, Kallidonis P, Kyriazis I, et al. Ureteral obstruction: is the full metallic double-pigtail stent the way to go? Eur Urol. 2010;57:480–7.CrossRef Liatsikos E, Kallidonis P, Kyriazis I, et al. Ureteral obstruction: is the full metallic double-pigtail stent the way to go? Eur Urol. 2010;57:480–7.CrossRef
8.
go back to reference Ito Y, Kikuchi E, Tanaka N, Miyajima A, Mikami S, Jinzaki M, Oya M. Preoperative hydronephrosis grade independently predicts worse pathological outcomes in patients undergoing nephroureterectomy for upper tract urothelial carcinoma. J Urol. 2011;185(5):1621–6.CrossRef Ito Y, Kikuchi E, Tanaka N, Miyajima A, Mikami S, Jinzaki M, Oya M. Preoperative hydronephrosis grade independently predicts worse pathological outcomes in patients undergoing nephroureterectomy for upper tract urothelial carcinoma. J Urol. 2011;185(5):1621–6.CrossRef
9.
go back to reference Vaglio A, Salvarani C, Buzio C. Retroperitoneal fibrosis. Lancet. 2006;367(9506):241–51.CrossRef Vaglio A, Salvarani C, Buzio C. Retroperitoneal fibrosis. Lancet. 2006;367(9506):241–51.CrossRef
10.
go back to reference Vaglio A, Maritati F. Idiopathic retroperitoneal fibrosis. J Am Soc Nephrol. 2016;27(7):1880–9.CrossRef Vaglio A, Maritati F. Idiopathic retroperitoneal fibrosis. J Am Soc Nephrol. 2016;27(7):1880–9.CrossRef
11.
go back to reference Oshiro H, Ebihara Y, Serizawa H, et al. Idiopathic retroperitoneal fibrosis associated with immunohematological abnormalities. Am J Med. 2005;118(7):782–6.CrossRef Oshiro H, Ebihara Y, Serizawa H, et al. Idiopathic retroperitoneal fibrosis associated with immunohematological abnormalities. Am J Med. 2005;118(7):782–6.CrossRef
12.
go back to reference Neild GH, Rodriguez-Justo M, Wall C, Connolly JO. Hyper-IgG4 disease: report and characterisation of a new disease. BMC Med. 2006;6(4):23.CrossRef Neild GH, Rodriguez-Justo M, Wall C, Connolly JO. Hyper-IgG4 disease: report and characterisation of a new disease. BMC Med. 2006;6(4):23.CrossRef
13.
go back to reference Fernando A, Pattison J, Horsfield C, D’Cruz D, Cook G, O’Brien T. [18F]-fluorodeoxyglucose positron emission tomography in the diagnosis, treatment stratification, and monitoring of patients with retroperitoneal fibrosis: a prospective clinical study. Eur Urol. 2017;71(6):926–33.CrossRef Fernando A, Pattison J, Horsfield C, D’Cruz D, Cook G, O’Brien T. [18F]-fluorodeoxyglucose positron emission tomography in the diagnosis, treatment stratification, and monitoring of patients with retroperitoneal fibrosis: a prospective clinical study. Eur Urol. 2017;71(6):926–33.CrossRef
14.
go back to reference Benson AD, Taylor ER, Schwartz BF. Metal ureteral stent for benign and malignant ureteral obstruction. J Urol. 2011;185:2217–22.CrossRef Benson AD, Taylor ER, Schwartz BF. Metal ureteral stent for benign and malignant ureteral obstruction. J Urol. 2011;185:2217–22.CrossRef
15.
go back to reference Polcari AJ, Hugen CM, López-Huertas HL, et al. Cost analysis and clinical applicability of the resonance metallic ureteral stent. Expert Rev Pharmacoecon Outcomes Res. 2010;10:11–5.CrossRef Polcari AJ, Hugen CM, López-Huertas HL, et al. Cost analysis and clinical applicability of the resonance metallic ureteral stent. Expert Rev Pharmacoecon Outcomes Res. 2010;10:11–5.CrossRef
16.
go back to reference López-Huertas HL, Polcari AJ, Acosta-Miranda A, et al. Metallic ureteral stents: a cost-effective method of managing benign upper tract obstruction. J Endourol. 2010;24:483–5.CrossRef López-Huertas HL, Polcari AJ, Acosta-Miranda A, et al. Metallic ureteral stents: a cost-effective method of managing benign upper tract obstruction. J Endourol. 2010;24:483–5.CrossRef
17.
go back to reference Wang HJ, Lee TY, Luo HL, et al. Application of resonance metallic stents for ureteral obstruction. BJU Int. 2011;108(3):428–32.CrossRef Wang HJ, Lee TY, Luo HL, et al. Application of resonance metallic stents for ureteral obstruction. BJU Int. 2011;108(3):428–32.CrossRef
18.
go back to reference Moskovitz B, Halachmi S, Nativ O. A new self-expanding, large-caliber ureteral stent: results of a multicenter experience. J Endourol. 2012;26(11):1523–7.CrossRef Moskovitz B, Halachmi S, Nativ O. A new self-expanding, large-caliber ureteral stent: results of a multicenter experience. J Endourol. 2012;26(11):1523–7.CrossRef
19.
go back to reference Elsamra SE, Motato H, Moreira DM, et al. Tandem ureteral stents for the decompression of malignant and benign obstructive uropathy. J Endourol. 2013;27(10):1297–302.CrossRef Elsamra SE, Motato H, Moreira DM, et al. Tandem ureteral stents for the decompression of malignant and benign obstructive uropathy. J Endourol. 2013;27(10):1297–302.CrossRef
Metadata
Title
The Resonance and the Allium ureteral stents in the treatment of non-malignant refractory ureterostenosis
Authors
Wei Gao
Tianying Xing
Tongwen Ou
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2021
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/s12894-021-00815-6

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