Auto-expandable metallic ureteral stents for complex ureteral stenosis: long term outcomes in a tertiary institution.

Abstract

Introduction: Auto-expandable ureteral stents can be an alternative to percutaneous nephrostomy (PCN) in refractory ureteral stenosis. Our aim is to analyse results and complications of ureteral stents in our centre.

Methods: Retrospective review of OptiMed® expandable ureteral stents placed in our centre (1996-2022). Analysis of complications (Clavien-Dindo classification). Kaplan-Meier curves (long-rank test) to assess stent permeability and Cox regression for associated factors.

Results: 58 patients were included. Median follow-up: 36 months (11-82). Median age: 61 years (48-68). Most frequent aetiology of ureteral stenosis was malignancy in 30 cases (53.6%). The most common location of stricture was distal ureter in 44 (63.8%) ureteral strictures. Creatinine levels improved in 28(48.3%) cases. Most common acute complication was UTI in 6(3.4%) patients (Clavien-Dindo II). 20 patients presented with stent obstruction. 14(24.1%) were solved with double J stenting and 6(10.3%) cases with PCN. Mean stent survival time was 50 months (34.3-65.8). By the end of follow up, 23(39.6%) patients were alive. Of those, 9(39.1%) had a functioning stent. No association of any factor with patency of stent was found.

Conclusions: Expandable ureteral stents are an alternative to PCN in fragile patients with refractory stenosis, which offers a better quality of life.