Purpose: We report our experience with the use of metallic self-expand
able and balloon expandable stents for the treatment of malignant uret
eral obstruction. Materials and Methods: We treated 12 consecutive pat
ients with malignant ureteral obstruction, for a total of 14 ureters w
ith stents placed. We placed metallic balloon expandable stents in 6 p
atients and self-expandable metallic stents in the remaining 6. Mean p
atient age was 65 years and mean followup was 9 months (range 8 to 16)
. Results: Of the ureters 11 were patent without any additional manipu
lations during followup of 8 to 16 months. Secondary interventions wer
e needed in 3 cases because of obstructive urothelial hyperplastic rea
ction, tumor ingrowth and local recurrence of the primary cancer invad
ing the upper end of the stent. Two patients died 2 and 10 months afte
r placement of the stent. Conclusions: Both types of metal stents have
advantages and disadvantages that must be balanced against each other
when choosing the ideal device for the treatment of obstruction. Impl
antation of a metal self-expanding or balloon expanding stent is safe
and effective for the palliative treatment of malignant ureteral obstr
uction in late stage cancer patients.