Comparison of single and tandem ureteral stenting for malignant ureteral obstruction: a prospective study of 104 patients

Abstract Purpose To evaluate nonprocedural percutaneous nephrostomy (PCN) complications and assess whether the protocol of routine 3-month exchange of PCN is optimal in patients with malignant ureteral obstruction (MUO) and benign ureteral obstruction (BUO). Materials and Methods Retrospective study of 103 patients with a mean age of 48 years (36 men, 67 women) who underwent PCN placement and subsequent PCN exchanges between January 2011 and January 2014 at the institution was conducted. Comparisons of the number of catheter days for those with routine exchange and emergency exchange due to tube obstruction, infection, and mechanical failures were made in patients with MUO and BUO. Results Of the 256 PCN exchange procedures, 139 were performed in the cancer cohort and 117 in the noncancer cohort. Complications requiring emergent exchanges were more common in cancer patients, particularly due to obstruction, which accounted for 57% of exchanges in MUO with a median onset of 50 days. In contrast, the majority of noncancer patients in this study did not require emergent exchange before 3 months. Routine exchanges accounted for 43% and 55% of exchanges in MUO and BUO, respectively. In both the groups, only a small proportion of emergent tube exchanges occurred beyond 105 days. Conclusion A routine 3-month nephrostomy exchange protocol may not be ideal for all patients. The optimal timing for exchange of nephrostomy appears to be earlier for patients with MUO compared with those with BUO. A prospective study is required to define an optimal policy for postprocedural nephrostomy tube care in both the cohorts.

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The resonance® metallic ureteral stent in the treatment of malignant ureteral obstruction: a prospective observational study

BMC Urology ◽

10.1186/s12894-019-0569-y ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Jun Miyazaki ◽

Mizuki Onozawa ◽

Satoshi Takahashi ◽

Yuka Maekawa ◽

Mitsuru Yasuda ◽

...

Keyword(s):

Ureteral Obstruction ◽

Ureteral Stent ◽

Stent Insertion ◽

Ureteral Stricture ◽

Metallic Stent ◽

Ureteric Stenting ◽

Malignant Ureteral Obstruction ◽

Ureteral Stenting ◽

The Difference

Abstract Background To study the outcomes and experiences of using metallic stents in treating patients with malignant ureteral obstruction (MUO), we examined the effects of metallic ureteral stenting using the Cook Resonance® stent in the treatment of MUO. Methods All patients who had a Resonance metallic stent inserted between April 2015 and March 2018 at one of multiple facilities were prospectively observed with a 1-year follow-up. The primary outcome was the patency rate of the metallic ureteral stent. The secondary outcomes included the complications (e.g., infection and fever). Results Although stent insertion was attempted in 50 patients, the stent could not be inserted as a ureteral stent in three patients due to severe ureteral stricture, and one ureteral cancer patient was excluded from the analysis. The remaining 46 patients’ median age was 67 years (range 28–85 years) (16 males, 30 females). Twenty-four patients died during the study; their median survival time was 226 days. The median follow-up period for the censored patients was 355 days (range 16–372 days), and just seven patients were still alive without Resonance failure > 1 year later. The women’s IPSS scores tended to be lower than those of the men. Regarding the OABSS score, although the women’s total score tended to be low, the difference between the men’s and women’s scores was nonsignificant. The bacteria detected from urine culture after stent insertion were more gram-positive than gram-negative. Conclusion Metallic ureteric stenting using the Resonance stent is safe and effective for treating MUO. Subjective symptoms were relatively less in the female patients.

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Noninvasive Assessment of Acute Ureteral Obstruction with Diffusion-weighted MR Imaging: A Prospective Study

Radiology ◽

10.1148/radiol.2523082090 ◽

2009 ◽

Vol 252 (3) ◽

pp. 721-728 ◽

Cited By ~ 61

Author(s):

Harriet C. Thoeny ◽

Tobias Binser ◽

Beat Roth ◽

Thomas M. Kessler ◽

Peter Vermathen

Keyword(s):

Mr Imaging ◽

Prospective Study ◽

Ureteral Obstruction ◽

Diffusion Weighted ◽

Noninvasive Assessment ◽

A Prospective Study

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Iatrogenic Tumor Seeding After Ureteral Stenting in a Dog with Urothelial Carcinoma

Journal of the American Animal Hospital Association ◽

10.5326/jaaha-ms-5865 ◽

2013 ◽

Vol 49 (4) ◽

pp. 262-266 ◽

Cited By ~ 6

Author(s):

Kenji Hosoya ◽

Satoshi Takagi ◽

Masahiro Okumura

Keyword(s):

Urothelial Carcinoma ◽

Ureteral Obstruction ◽

Bladder Neck ◽

Clinical Signs ◽

Histologic Examination ◽

Tumor Seeding ◽

Percutaneous Puncture ◽

Malignant Ureteral Obstruction ◽

Ureteral Stenting ◽

The Masses

A 5 yr old castrated male miniature dachshund presented with clinical signs attributable to carcinoma involving the bladder neck and prostate. On day 84 following diagnosis, the dog developed bilateral ureteral obstruction and ureteral stenting was attempted. The stents were inserted in a normograde fashion via percutaneous puncture of the dilated renal pelvises. Two wk later, the dog developed nodules at both sites of renocentesis. En block resection of the masses was performed, and histologic examination confirmed that the masses were urothelial carcinoma, likely caused by iatrogenic tumor seeding. Ureteral stenting is a useful technique to relieve malignant ureteral obstruction; however, risk of iatrogenic tumor seeding must be considered.

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Retrograde pyelography predicts retrograde ureteral stenting failure and reduces unnecessary stenting trials in patients with advanced non-urological malignant ureteral obstruction

PLoS ONE ◽

10.1371/journal.pone.0184965 ◽

2017 ◽

Vol 12 (9) ◽

pp. e0184965 ◽

Cited By ~ 5

Author(s):

Sung Han Kim ◽

Boram Park ◽

Jungnam Joo ◽

Jae Young Joung ◽

Ho Kyung Seo ◽

...

Keyword(s):

Ureteral Obstruction ◽

Retrograde Pyelography ◽

Malignant Ureteral Obstruction ◽

Ureteral Stenting

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Post- hysterectomy Transient Hydronephrosis: A Prospective Study

Journal of Family & Reproductive Health ◽

10.18502/jfrh.v15i1.6068 ◽

2021 ◽

Author(s):

Mandana Mansour Ghanaie ◽

Seyed Alaedin Asgari ◽

Azar Haghbin ◽

Fahime Mehdizade ◽

Seyed Mohammad Asgari Ghalebin

Keyword(s):

Prospective Study ◽

Uterine Prolapse ◽

Abnormal Uterine Bleeding ◽

Intravenous Urography ◽

Ureteral Injury ◽

Benign Diseases ◽

Total Hysterectomy ◽

Ureteral Stenting ◽

The Right ◽

A Prospective Study

Objective: To determine the incidence and importance of transient asymptomatic hydronephrosis following total hysterectomy. Materials and methods: In a prospective study over 4 year, 368 women were studied who had undergone a total abdominal or vaginal hysterectomy. Totally, 95% of operations were done for benign diseases (abnormal uterine bleeding, chronic pelvic pain, uterine prolapse, etc.) and 5% were performed for uterine malignancy. Renal ultrasonography was performed before and 3, 7 and 28 days after the surgery for diagnosing hydronephrosis. Intravenous urography was performed in patients with either persistent/progressive or symptomatic hydronephrosis. Results: There was no intraoperative identifiable ureteral injury. Hydronephrosis was seen in 35 (9.5%), 21 (5.7%), and 1 (0.27%) patients at days 3, 7 and 28 after the operation, respectively. The degree of hydronephrosis was graded I, II or III. Considering the frequency and severity of hydronephrosis, the right kidney was affected more. Hydronephrosis correlated significantly with indication, duration and route of surgery as well as patient's age. All kidneys improved spontaneously, except one case which needed ureteral stenting with no surgical intervention (p=0.05). Conclusion: Transient hydronephrosis could occur after simple total hysterectomy despite the absence of any obvious intraoperative ureteral injury. It is noted in 9.5% of the patients within three days after the non-complicated surgery. The clinical course may be continued until one month.

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