Metallic stents for malignant and benign ureteric obstruction

Objective To report our experience of using metallic stents to treat ureter ic obstruction caused by malignant or benign disease, Patients and methods Nine patients with obstruction in 11 ureters caused by malignant or benign disease (mean age 61 years, range 35-82, mean follow-u p 7 months, range 3-11) were treated using metallic stents. A balloon-expan dable metallic stent was used in one patient and self-expandable metallic s tents in the remaining eight. All stents were inserted via a percutaneous a ntegrade approach. Results Of the 11 ureters, nine remained patent with no further manipulatio n during the follow-up of 3-months. An additional stent was placed in conti nuity with the first in two ureters of two patients at 4 and 5 weeks after the first procedure because of persistent obstruction, After the second int ervention, their obstruction was improved. Transient vesicoureteric reflux occurred in two of three stented distal ureters, but the reflux resolved sp ontaneously within 2 months after stent implantation. Ureteric patency was maintained in all patients and no major complications related to stenting o ccurred during the follow-up. Two patients died from cervical cancer at 3 a nd 5 months after stenting, Conclusion In patients with difficult ureteric obstructions a metallic sten t provides a safe and effective alternative to an indwelling double-pigtail catheter or percutaneous nephrostomy.