METAL STENTS - A NEW TREATMENT OF MALIGNANT URETERAL OBSTRUCTION

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.