Metal mesh stents for ureteral obstruction caused by hormone-resistant carcinoma of prostate

Background: Long-segment ureteral obstruction by hormone-refractory carcino ma of the prostate is a difficult problem to manage. J-Stents often obstruc t by compression, Metal mesh stents have been used successfully in the mana gement of extrinsic ureteral obstruction caused by malignant disease. In th is paper, we review our results in three patients in terms of the defined o bjective of palliation, Patients and Methods: All three patients presented with painful obstructed kidneys and renal failure from long (7-10-cm) distal ureteral strictures re sponding to nephrostomy drainage. Endoluminal metal mesh stents of 7 to 8-m m diameter of various lengths (depending on the size of the stricture) were implanted after antegrade balloon dilatation of the stricture by a standar d technique, The case notes were reviewed for technical success, preservati on of the renal units, complications, and the impact on the overall quality of life, Results: All three stents were placed without any complication and showed p atency on contrast study. In one patient, the stent obstructed after 5 mont hs, necessitating placement of a nephrostomy tube, In the remaining two pat ients, the stents obstructed within 3 months. During these 3 months, both p atients had multiple admissions for stent-related complications and other s ymptoms of their disease, Overall quality of life was poor for these patien ts, Conclusion: Metal mesh ureteral stents give poor palliation in distal stric tures caused by hormone-refractory carcinoma of the prostate. Permanent nep hrostomy may be a more acceptable alternative in these patients with short life expectancies.