Initial experience with a newly developed antirefluxive ureter stent.

Urological Research Pub Date : 2012-08-01 Epub Date: 2011-08-18 DOI:10.1007/s00240-011-0415-5
Manuel Ritter, Patrick Krombach, Thomas Knoll, Maurice Stephan Michel, Axel Haecker
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引用次数: 25

Abstract

The objective of this study was to assess the functional efficacy of newly developed antirefluxive ureter stents (DJ), by performing immediate post-stenting cystograms on patients with acute ureteral obstruction requiring a DJ stent, and assessing stent-related symptoms by means of ureteral stent symptoms questionnaire (USSQ). Patients with acute hydronephrosis requiring internal drainage were randomized to receive either an antirefluxive DJ or a conventional DJ (7 Fr., 26 cm, polyurethane, Urovision(®), Germany). Mean stone size was 6.64 ± 3.33 and 6.5 ± 3.54 mm. Immediately after correct placement of the DJ, 200 ml of diluted contrast media was introduced into the bladder under fluoroscopic control to detect vesicoureteral reflux (VUR). Patients completed German versions of the USSQ on days 2 and 7 following stent placement, and 1 week after stent removal. The results were analyzed. 13 conventional and 16 antirefluxive stents were placed in 29 patients. Reflux was documented in eight conventionally stented patients (62.5%). Two of the 16 patients with antirefluxive stents (22%) presented reflux. 1 week after stent implantation, the mean pain value was 1.1 in the antirefluxive group and 3 in the standard group (p < 0.062). Flank pain during micturition occurred after 2 days in seven patients (58%) with standard stents and in three patients (33%) with antirefluxive stents (p < 0.23). 1 week after stent insertion, flank pain had dropped to 40% in the standard group and 11% in the antirefluxive group (p < 0.3). Our initial experience showed that the antirefluxive system might be effective in terms of reflux prevention and reduction of stent related symptoms especially during sexual intercourse.

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新开发的抗反流输尿管支架的初步经验。
本研究的目的是评估新开发的抗反流输尿管支架(DJ)的功能疗效,方法是对需要DJ支架的急性输尿管梗阻患者进行支架植入后立即膀胱造影,并通过输尿管支架症状问卷(USSQ)评估支架相关症状。需要内引流的急性肾积水患者随机接受抗反流DJ或常规DJ (7 Fr, 26 cm,聚氨酯,Urovision(®),德国)。平均结石大小分别为6.64±3.33 mm和6.5±3.54 mm。在正确放置DJ后,在透视控制下立即将200 ml稀释造影剂注入膀胱,以检测膀胱输尿管反流(VUR)。患者在支架放置后第2天和第7天以及支架移除后1周完成德文版USSQ。对结果进行分析。在29例患者中放置了13个常规支架和16个抗反流支架。8例常规支架患者(62.5%)出现反流。16例植入抗反流支架的患者中有2例(22%)出现反流。支架置入术后1周,抗反流组的平均疼痛值为1.1,标准组的平均疼痛值为3 (p < 0.062)。标准支架组7例(58%)和抗反流支架组3例(33%)患者在2天后排尿时腹痛(p < 0.23)。支架置入1周后,标准组和抗反流组腰痛发生率分别降至40%和11% (p < 0.3)。我们的初步经验表明,抗反流系统在预防反流和减少支架相关症状方面可能是有效的,特别是在性交期间。
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来源期刊
Urological Research
Urological Research 医学-泌尿学与肾脏学
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6-12 weeks
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