BERKELEY, CA (UroToday.com) - In this recent publication in the International Brazilian Journal of Urology, we assess the patency rates of patients with chronic upper urinary tract obstruction managed using metallic ureteral stents, obviating the need for frequent stent exchanges. We report our clinical experiences with the use of these stents in the management of poor ureteral drainage.
In a prospective cohort of 50 patients undergoing metallic ureteral stent placement between 2009 and 2012, we assessed the outcomes of our patients managed in this manner. Stent failure was defined as an unplanned stent exchange, need for nephrostomy tube placement, increasing hydronephrosis with stent in place, or an elevation in serum creatinine. Stent life was analyzed using the Kaplan-Meier methodology as this was a time-dependent continuous variable. A cost analysis was similarly conducted.
A total of 97 metallic stents were placed among our cohort of patients, with 63 placed in cases of malignant obstruction, 33 in the setting of cutaneous ureterostomies, and 1 in an ileal conduit urinary diversion. Overall, stent failure occurred in 8.2% of the stents placed. Median stent life was 288.4 days (95% CI: 277.4-321.2 days). The estimated annual cost for traditional polymer stents (exchanged every 90 days) was $9,648-$13,128, while the estimated cost for metallic stents is $4,211-$5,313.
In conclusion, our results indicate that metallic ureteral stent placement is a technically feasible procedure with minimal complications and is well tolerated among patients. Metallic stents can be left in situ for longer durations and provide a significant financial benefit when compared to traditional polymer stents.
Written by:
Philippe E. Spiess, MD, MSc, FACS, FRCS(C) as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Department of Genitourinary Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612 USA
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