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15-YEAR EXPERIENCE WITH THE MANAGEMENT OF EXTRINSIC URETERAL OBSTRUCTION WITH INDWELLING URETERAL STENTS

2004; Lippincott Williams & Wilkins; Volume: 172; Issue: 2 Linguagem: Inglês

10.1097/01.ju.0000130510.28768.f5

1527-3792

Steve Y. Chung, Robert J. Stein, Douglas Landsittel, Ben Davies, David C. Cuellar, Ronald L. Hrebinko, Tatum Tarin, Timothy D. Averch,

Renal and Vascular Pathologies

No AccessJournal of UrologyAdult Urology: Voiding Dysfunction1 Aug 200415-YEAR EXPERIENCE WITH THE MANAGEMENT OF EXTRINSIC URETERAL OBSTRUCTION WITH INDWELLING URETERAL STENTS STEVE Y. CHUNG, ROBERT J. STEIN, DOUGLAS LANDSITTEL, BENJAMIN J. DAVIES, DAVID C. CUELLAR, RONALD L. HREBINKO, TATUM TARIN, and TIMOTHY D. AVERCH STEVE Y. CHUNGSTEVE Y. CHUNG , ROBERT J. STEINROBERT J. STEIN , DOUGLAS LANDSITTELDOUGLAS LANDSITTEL , BENJAMIN J. DAVIESBENJAMIN J. DAVIES , DAVID C. CUELLARDAVID C. CUELLAR , RONALD L. HREBINKORONALD L. HREBINKO , TATUM TARINTATUM TARIN , and TIMOTHY D. AVERCHTIMOTHY D. AVERCH View All Author Informationhttps://doi.org/10.1097/01.ju.0000130510.28768.f5AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We assessed the success of retrograde placement of indwelling ureteral stents in the management of ureteral obstruction due to extrinsic compression. Materials and Methods: Between July 1987 and December 2002 adequate followup was available for 101 patients who underwent primary retrograde ureteral stenting for extrinsic ureteral obstruction. Mean age at presentation was 61.4 years (range 33 to 90). Chart review was performed on all patients for primary diagnosis, symptomatology, degree of hydronephrosis, creatinine levels (baseline, treatment and posttreatment), location of compression, size and number of stents used, progression to percutaneous nephrostomy tube (PNT), stent failure, days to stent failure, post-stent therapy and status at last followup. Results: Mean length of followup was 11 months (range 1 to 127). In 101 patients 138 ureteral units (UU) were stented. Total stent failure occurred in 41 (40.6%) patients and 58 (42.0%) UU. A total of 40 (29.0%) UU required PNTs at a mean of 40.3 days (range 0 to 330) with 18 PNTs placed in less than 1 week. Cases of stent failure that did not undergo PNT placement included 18 (13.0%) UU at a mean of 52.4 days (range 3 to 128). A total of 90 (89.1%) patients had metastatic cancer at stenting with 32.2% dead at 5.8 months (range 1 to 32). Univariate and multivariate analyses identified cancer diagnosis, baseline creatinine greater than 1.3 mg/dl and post-stent systemic treatment as predictors of stent failure. Proximal location of compression and treatment creatinine greater than 3.11 mg/dl were marginal predictors of failure on univariate analysis, while proximal location of obstruction was also marginally significant on multivariate analysis. No predictors were identified for early stent failure (less than 1 week). Conclusions: At almost 1 year followup stent failure due to extrinsic compression occurred in nearly half of treated patients. 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Link, Google Scholar From the Department of Urology (SYC, RJS, BJD, DCC, RLH, TT, TDA), University of Pittsburgh Medical Center, and Biostatistics (DL), University of Pittsburgh, Pittsburgh, Pennsylvania© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byFrederick L, Ellimoottil C, Kadlec A, Shah A, Turk T and Schwartz B (2016) Cost Analysis of Metallic Stents for Chronic Ureteral Obstruction: A Multicenter StudyUrology Practice, VOL. 4, NO. 1, (21-24), Online publication date: 1-Jan-2017.Kadlec A, Ellimoottil C, Greco K and Turk T (2013) Five-Year Experience with Metallic Stents for Chronic Ureteral ObstructionJournal of Urology, VOL. 190, NO. 3, (937-941), Online publication date: 1-Sep-2013.Goldsmith Z, Wang A, Bañez L, Lipkin M, Ferrandino M, Preminger G and Inman B (2012) Outcomes of Metallic Stents for Malignant Ureteral ObstructionJournal of Urology, VOL. 188, NO. 3, (851-855), Online publication date: 1-Sep-2012.Benson A, Taylor E and Schwartz B (2011) Metal Ureteral Stent for Benign and Malignant Ureteral ObstructionJournal of Urology, VOL. 185, NO. 6, (2217-2222), Online publication date: 1-Jun-2011.Izumi K, Mizokami A, Maeda Y, Koh E and Namiki M (2010) Current Outcome of Patients With Ureteral Stents for the Management of Malignant Ureteral ObstructionJournal of Urology, VOL. 185, NO. 2, (556-561), Online publication date: 1-Feb-2011.Liatsikos E, Karnabatidis D, Katsanos K, Kallidonis P, Katsakiori P, Kagadis G, Christeas N, Papathanassiou Z, Perimenis P and Siablis D (2009) Ureteral Metal Stents: 10-Year Experience With Malignant Ureteral Obstruction TreatmentJournal of Urology, VOL. 182, NO. 6, (2613-2618), Online publication date: 1-Dec-2009.Christman M, L'Esperance J, Choe C, Stroup S and Auge B (2008) Analysis of Ureteral Stent Compression Force and its Role in Malignant ObstructionJournal of Urology, VOL. 181, NO. 1, (392-396), Online publication date: 1-Jan-2009.GANATRA A and LOUGHLIN K (2018) The Management of Malignant Ureteral Obstruction Treated with Ureteral StentsJournal of Urology, VOL. 174, NO. 6, (2125-2128), Online publication date: 1-Dec-2005. Volume 172Issue 2August 2004Page: 592-595 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordspressureureteral obstructionstentsMetricsAuthor Information STEVE Y. CHUNG More articles by this author ROBERT J. STEIN More articles by this author DOUGLAS LANDSITTEL More articles by this author BENJAMIN J. DAVIES More articles by this author DAVID C. CUELLAR More articles by this author RONALD L. HREBINKO More articles by this author TATUM TARIN More articles by this author TIMOTHY D. AVERCH More articles by this author Expand All Advertisement PDF downloadLoading ...