WorldJUrolDOI10.1007/s00345-008-0245-4123ORIGINALARTICLEInitialclinicalexperiencewithfull-lengthmetalureteralstentsforobstructiveureteralstenosisUdoNagele·MarkusA.Kuczyk·MarcusHorstmann·JörgHennenlotter·Karl-DietrichSievert·DavidSchilling·UteWalcher·ArnulfStenzl·AristotelisG.AnastasiadisReceived:11October2007/Accepted:13February2008©Springer-Verlag2008AbstractObjectivesLong-termureteralstentingisusedtoensureurinarydrainageifareconstructiveapproachorareleaseofanextrinsicobstructionisnotpossible.Inthiscontribution,along-termexperiencewithanewfull-length,metalindwellingstentispresented.MethodsFourteenpatientswithureteralobstructionreceivedfullmetalindwellingstentsin18collectingsys-tems(benigndiseasein5andmalignantdiseasein13).StentplacementwasperformedcystoscopicallyunderXuo-roscopicguidance.Follow-upwasdoneevery3monthswithultrasonographicexamination,creatininelevels,andavisualanalogpainscore.ResultsEightstentswereremoved,whereaseightarestillinsitu.Onepatientwithoutstent-relatedproblemsdiedbecauseofprogressiverectalcancer9monthsafterbilateralstentinsertion.Meanstentduration(8stentsstillinsitu)is8.6months,whereasmeanstentdurationforbenignandmalignantdiseaseis11.8(median13)and7.3(median6)months,respectively(p<0.05).Allremovedstentswereextractedendoscopicallywithoutanyproblemsandhadnoincrustationexcepttwo.Neithermigrationnormechanicaldamagewasobserved.ConclusionThisnovelstentiseasytoinsertandremove.Itisanoptionforpatientsinwhichasurgicalreconstruc-tionoftheobstructedureterisnotpossible.Stentshavebeendevelopedfurtherandarenowavailableinvariouslengths.Thismightresultinareductionofproblemsasso-ciatedwithinadequatestentlengthandshouldincreasepatientcomfortandstentdurability.KeywordsUreteralobstruction·Endourology·MetalstentIntroductionTheaimoflong-termureteralstentinginthecaseofobstructionoftheupperurinarytractistoensureurinarydrainagefromthekidneytothebladder,ifareconstructiveapproachcannotbeachievedduetopatientstatusorifareleaseofanextrinsicobstructionisnotpossiblebymedi-calorinterventionaltreatments.However,thelong-termfailurerateofindwellingureteralstentsishigh[1,2].Ontheotherhand,placementofanephrostomytubedecreasesqualityoflife,isapossibleentrysiteforbacteriaandtherefore,apossiblesourceofinfection.Thelattershouldbeavoided,especiallyinpatientsundergoingchemo-and/orimmunotherapy.Variousexpandableshortmetalstentshavebeenusedwithinthelastdecade.Exactplacement,biocompatibility,aswellasWnancialissuesareongoingmattersofdebateregardingcomfortandfeasibilityofthisformofurinarydrainage[3].Inthiscontribution,aninitialclinicalexperi-encewithafull-lengthmetalindwellingstentispresentedfor14patients.MaterialsandmethodsPatientrecruitmentandcharacteristicsBetween6May2005and3November2005,14patientswithureteralobstructionreceivedfullmetalindwellingU.Nagele(&)·M.A.Kuczyk·M.Horstmann·J.Hennenlotter·K.-D.Sievert·D.Schilling·U.Walcher·A.Stenzl·A.G.AnastasiadisDepartmentofUrology,UniversityofTuebingen,Hoppe-Seyler-Str.3,72076Tuebingen,Germanye-mail:Udo.Nagele@med.uni-tuebingen.de;miriam.germann@med.uni-tuebingen.deWorldJUrol123stents.Inclusioncriteriawereobstructionoftheupperuri-narytract,inwhichareconstructiveapproachcouldnotbeachievedduetopatientstatusorifareleaseofanextrinsicobstructionwasnotpossiblebymedicalorinterventionaltreatments.Suchpatients,eitherwithindwellingstents,w...
