Antegrade stenting for chronic malignant ureteral obstruction with the Resonance® metallic stent: a case series.

Purpose: Polymeric and metallic stents are commonly used to manage patients with chronic malignant ureteric obstruction (CMUO). This paper compares the outcomes of ureteral stenting via the Resonance^® metallic stent against its polymeric counterpart in published literature, as well as between antegrade and retrograde approaches.

Methods: A retrospective case series was conducted whereby patients who had undergone Resonance^® stent insertions via an antegrade route from June 2022 to May 2023 were reviewed through our electronic medical record system. Descriptive statistics were used to summarise patient demographics and clinical outcomes.

Results: 11 patients who presented with CMUO underwent 12 separate procedures of either unilateral or bilateral ureteral stenting. Total number of stents inserted was 16. Median age of patients was 65 (Range = 32) and 72.73% were males. 66.67% of the procedures yielded an improvement in the estimated glomerular filtration rate (eGFR) in patients as compared to before stenting. Stent failure, defined by stent removal before recommended removal date, occurred in 4 out of 16 (25%) stents. The median duration of Resonance^® stent in situ at the time of data collection (4th December 2023) was 245 days.

Conclusion: We conclude that the Resonance^® stent is more effective at providing long term urinary drainage for CMUO, compared to its polymeric counterpart. However, antegrade insertion of the Resonance^® stent does not significantly decrease indwelling stent duration compared to retrograde insertion.