Allium ureteral stent for the treatment of ureteral stricture and fistula after abdominal surgery

Background When antegrade ureteral intervention fails due to severe ureteral stricture or tortuosity, a longer sheath can be used to facilitate ureteral catheterization. Purpose To evaluate the feasibility and effectiveness of the use of a long sheath in antegrade ureteral stent placement after failure of antegrade ureteral stent placement using a short sheath. Material and Methods Among 1284 procedures in 934 patients who received ureteral stent placement, a long sheath was used after stricture negotiation failure using a short sheath in 57 (4.4%) procedures in 53 patients. The data of these 53 patients were retrospectively reviewed. Results The most common reasons for long sheath use were failure of balloon catheter (59.6%) or guidewire (29.8%) advancement across the stricture. Technical success, successful stricture negotiation after using a long sheath, was achieved in 50/57 (87.7%) procedures. In two of seven failed procedures, an additional TIPS sheath was used and the technical success rate improved to 91.2% (52/57). The technical success rate was significantly higher in the patients who have failed balloon catheter advancement (97.1%, 33/34) than the patients who have failed guidewire advancement (64.7%, 11/17) (Fisher’s exact test, P = 0.004). Self-limiting hematoma occurred in one patient after use of the long sheath and was considered a minor complication. Conclusion Ureteral catheterization using a long sheath is feasible and effective when antegrade ureteral intervention using a short sheath fails. When using a long sheath, the technical success rate was higher when advancing the balloon catheter over the guidewire than when advancing the guidewire through tight stricture.

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Ureteral stent versus no ureteral stent for ureteroscopy in the management of renal and ureteral calculi: A Cochrane review

Canadian Urological Association Journal ◽

10.5489/cuaj.5957 ◽

2019 ◽

Vol 14 (2) ◽

Author(s):

Maria Ordonez ◽

Eu Chang Hwang ◽

Michael Borofsky ◽

Caitlin J. Bakker ◽

Shreyas Gandhi ◽

...

Keyword(s):

Stent Placement ◽

Cochrane Review ◽

Stone Disease ◽

Ureteral Stent ◽

Ureteral Stricture ◽

Time Intervals ◽

Comprehensive Search ◽

Publication Language ◽

Post Hoc ◽

Patients Experience

Introduction: We aimed to assess the effects of postoperative ureteral stent placement after uncomplicated ureteroscopy. Methods: We performed a comprehensive search with no restrictions on publication language or status up to February 1, 2019. We only included randomized trials. Two review authors independently examined full-text reports, identified relevant studies, assessed the eligibility of studies for inclusion, extracted data, and assessed risk of bias. We performed statistical analyses using a random-effects model and assessed the certainty of the evidence according to GRADE. Results: We included 23 studies with 2656 randomized patients. Primary outcomes: It is uncertain whether stenting reduces the number of unplanned return visits (very low CoE). Pain on the day of surgery is probably similar (mean difference [MD] 0.32; 95% confidence interval (CI) -0.13‒0.78; moderate CoE). Pain on postoperative days 1‒3 may show little to no difference (SMD 0.25; 95% CI -0.32‒0.82; low CoE). It is uncertain whether stented patients experience more pain on postoperative days 4‒30 (very low CoE). Stenting may result in little to no difference in the need for secondary interventions (relative risk [RR] 1.15; 95% CI 0.39‒3.33; low CoE). Secondary outcomes: We are uncertain whether stenting reduces the need for narcotics and reduces ureteral stricture rates up to 90 days (very low CoE). Rates of hospital admission may be slightly reduced (RR 0.70; 95% CI 0.32‒1.55; low CoE). This review was limited to patients in whom ureteroscopy was deemed ‘uncomplicated.’ In addition, time intervals for the grouping for the reported degree of pain were established post hoc. The CoE for most outcomes was rated as low or very low for methodological reasons. Conclusions: Findings of this review illustrate the tradeoffs of risks and benefits faced by urologists and their patients when it comes to decision-making about stent placement after uncomplicated ureteroscopy for stone disease.

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Dual ureteral stent placement after redo laser endoureterotomy to manage persistent ureteral stricture

IJU Case Reports ◽

10.1002/iju5.12152 ◽

2020 ◽

Vol 3 (3) ◽

pp. 93-95 ◽

Cited By ~ 1

Author(s):

Masahiko Isogai ◽

Shuzo Hamamoto ◽

Kenichi Hasebe ◽

Keitaro Iida ◽

Kazumi Taguchi ◽

...

Keyword(s):

Stent Placement ◽

Ureteral Stent ◽

Ureteral Stricture

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Ureteral Stent for Ureteral Stricture

Recent Advances in Endourology - Interventional Management of Urological Diseases ◽

10.1007/978-4-431-35642-4_5 ◽

2007 ◽

pp. 75-86 ◽

Cited By ~ 4

Author(s):

James F. Borin ◽

Elspeth M. McDougall

Keyword(s):

Ureteral Stent ◽

Ureteral Stricture

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129 What are factors that influence ureteral stent obstruction in patients with ureteral stricture?

European Urology Supplements ◽

10.1016/s1569-9056(16)60131-8 ◽

2016 ◽

Vol 15 (3) ◽

pp. e129-e129a

Author(s):

Y.H. Ko ◽

P.H. Song ◽

K.S. Lee ◽

J.Y. Choi ◽

H.C. Jung ◽

...

Keyword(s):

Ureteral Stent ◽

Ureteral Stricture

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Self-expanding metal ureteral stent for ureteral stricture: Experience of a large-scale prospective study from a high-volume center - Cross-sectional study

International Journal of Surgery ◽

10.1016/j.ijsu.2021.106161 ◽

2021 ◽

pp. 106161

Author(s):

Xiaoshuai Gao ◽

Turun Song ◽

Liao Peng ◽

Chi Yuan ◽

Wei Wang ◽

...

Keyword(s):

Prospective Study ◽

Large Scale ◽

High Volume ◽

Cross Sectional Study ◽

Ureteral Stent ◽

Ureteral Stricture ◽

Sectional Study ◽

Cross Sectional ◽

High Volume Center

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Ureteral Stenting after Uncomplicated Ureteroscopy for Distal Ureteral Stones: A Randomized, Controlled Trial

Minimally Invasive Surgery ◽

10.1155/2014/892890 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Y. El Harrech ◽

N. Abakka ◽

J. El Anzaoui ◽

O. Ghoundale ◽

D. Touiti

Keyword(s):

Urinary Tract ◽

Ureteral Stent ◽

Ureteral Calculi ◽

Ureteral Stones ◽

Ureteral Stricture ◽

Stent Group ◽

Bladder Pain ◽

Significant Difference ◽

Group 3 ◽

Group 1

Objectives. We compared outcome and complications after uncomplicated ureteroscopic treatment of distal ureteral calculi with or without the use of ureteral stents.Materials and Methods. 117 patients, prospectively divided into three groups to receive a double j stent (group 1, 42 patients), ureteral stent (group 2, 37 patients), or no stent (group 3, 38 patients), underwent ureteroscopic treatment of distal ureteral calculi. Stone characteristics, operative time, postoperative pain, lower urinary tract symptoms (LUTS), analgesia need, rehospitalization, stone-free rate, and late postoperative complications were all studied.Results. There were no significant differences in preoperative data. There was no significant difference between the three groups regarding hematuria, fever, flank pain, urinary tract infection, and rehospitalisation. At 48 hours and 1 week, frequency/urgency and dysuria were significantly less in the nonstented group. When comparing group 1 and group 3, patients with double j stents had statistically significantly more bladder pain (P=0.003), frequency/urgency (P=0.002), dysuria (P=0.001), and need of analgesics (P=0.001). All patients who underwent imaging postoperatively were without evidence of obstruction or ureteral stricture.Conclusions. Uncomplicated ureteroscopy for distal ureteral calculi without intraoperative ureteral dilation can safely be performed without placement of a ureteral stent.

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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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