Intraureteral metallic endoprosthesis in the treatment of ureteral strictures

Objective: We report our experience on intraureteral metallic stents placem ent for the treatment of malignant and benign ureteral strictures. Methods: Eight patients (six men and two women) with inoperable malignant or benign ureteral strictures, underwent insertion of metallic stents through percut aneous tracts. Six lesions (three malignant, three benign) involved uretero intestinal anastomoses after cystectomy for bladder cancer and ureteroileal urinary diversion or bladder substitution, and two malignant lesions invol ved the midureter. Self-expandable stents were used in seven cases and a ba lloon-expandable stent in the retraining one case. One stent was sufficient in seven ureters, and in one ureter, two overlapping stents were placed. R esults: Metallic stents were inserted without technical difficulties in all obstructed ureters and patency was achieved in all patients. Ultrasonograp hy revealed resolution of pre-existing hydronephrosis. The duration of foll ow-up was 6-17 months (mean, 9 months). One ureter was occluded 8 months af ter stent placement because of ingrowth of tumor and granulation tissue. Th e other ureters showed no signs of obstruction during follow-up. No major c omplications directly attributable to the metallic stent occurred. Conclusi ons: Our results suggest that insertion of a metallic stent in the ureter i s feasible and safe for the treatment of benign or malignant ureteral stric tures. However, more work needs to be done to establish the use of these st ents for the treatment of ureteral obstruction. (C) 2001 Elsevier Science I reland Ltd. All rights reserved.