Metallic stents in gynecologic cancer: An approach to treat extrinsic ureteral obstruction

Objective: We report on our experience with the use of self-expandable meta l stents for the treatment of extramural ureteral obstruction in patients w ith gynecologic cancer to restore ureteral patency and to alleviate the ure terectasis and hydronephrosis proximal to the ureteral narrowing. Methods: Fourteen women (mean age 48 years) with obstructive uropathy secon dary to gynecologic malignancies were treated successfully by placement of Wallstent self-expandable intraureteral metallic stents. The patients were followed for a mean period of 15 (range 9-24) months. Results: Obstructive uropathy was resolved in all cases. In 1 patient place ment of an additional, totally coaxial, stent was considered necessary beca use of tumor ingrowth, occurring 6 months after the procedure. In another p atient, tumor overgrowth invading the borderline area between the proximal ureteric end and the metallic prosthesis was seen 12 months after stent pla cement causing obstruction. Thus, an additional Wallstent was implanted ove rlapping the initially placed stent. Patency was achieved in all the remain ing ureters, during the follow-up period, without any need for further inte rvention. Conclusion: Implantation of self-expandable metal stents is a safe and effe ctive method for bypassing ureteral obstruction due to gynecologic malignan cies. Copyright (C) 2000 S. Karger AG, Basel.