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Outcomes of metallic stents for malignant ureteral obstruction.

Publication ,  Journal Article
Goldsmith, ZG; Wang, AJ; Bañez, LL; Lipkin, ME; Ferrandino, MN; Preminger, GM; Inman, BA
Published in: J Urol
September 2012

PURPOSE: Malignant ureteral obstruction often necessitates chronic urinary diversion and is associated with high rates of failure with traditional ureteral stents. We evaluated the outcomes of a metallic stent placed for malignant ureteral obstruction and determined the impact of risk factors previously associated with increased failure rates of traditional stents. MATERIALS AND METHODS: Patients undergoing placement of the metallic Resonance® stent for malignant ureteral obstruction at an academic referral center were identified retrospectively. Stent failure was defined as unplanned stent exchange or nephrostomy tube placement for signs or symptoms of recurrent ureteral obstruction (recurrent hydroureteronephrosis or increasing creatinine). Predictors of time to stent failure were assessed using Cox regression. RESULTS: A total of 37 stents were placed in 25 patients with malignant ureteral obstruction. Of these stents 12 (35%) were identified to fail. Progressive hydroureteronephrosis and increasing creatinine were the most common signs of stent failure. Three failed stents had migrated distally and no stents required removal for recurrent infection. Patients with evidence of prostate cancer invading the bladder at stent placement were found to have a significantly increased risk of failure (HR 6.50, 95% CI 1.45-29.20, p = 0.015). Notably symptomatic subcapsular hematomas were identified in 3 patients after metallic stent placement. CONCLUSIONS: Failure rates with a metallic stent are similar to those historically observed with traditional polyurethane based stents in malignant ureteral obstruction. The invasion of prostate cancer in the bladder significantly increases the risk of failure. Patients should be counseled and observed for subcapsular hematoma formation with this device.

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Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

September 2012

Volume

188

Issue

3

Start / End Page

851 / 855

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Ureteral Obstruction
  • Treatment Outcome
  • Stents
  • Retrospective Studies
  • Prosthesis Design
  • Molybdenum
  • Male
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Goldsmith, Z. G., Wang, A. J., Bañez, L. L., Lipkin, M. E., Ferrandino, M. N., Preminger, G. M., & Inman, B. A. (2012). Outcomes of metallic stents for malignant ureteral obstruction. J Urol, 188(3), 851–855. https://doi.org/10.1016/j.juro.2012.04.113
Goldsmith, Zachariah G., Agnes J. Wang, Lionel L. Bañez, Michael E. Lipkin, Michael N. Ferrandino, Glenn M. Preminger, and Brant A. Inman. “Outcomes of metallic stents for malignant ureteral obstruction.J Urol 188, no. 3 (September 2012): 851–55. https://doi.org/10.1016/j.juro.2012.04.113.
Goldsmith ZG, Wang AJ, Bañez LL, Lipkin ME, Ferrandino MN, Preminger GM, et al. Outcomes of metallic stents for malignant ureteral obstruction. J Urol. 2012 Sep;188(3):851–5.
Goldsmith, Zachariah G., et al. “Outcomes of metallic stents for malignant ureteral obstruction.J Urol, vol. 188, no. 3, Sept. 2012, pp. 851–55. Pubmed, doi:10.1016/j.juro.2012.04.113.
Goldsmith ZG, Wang AJ, Bañez LL, Lipkin ME, Ferrandino MN, Preminger GM, Inman BA. Outcomes of metallic stents for malignant ureteral obstruction. J Urol. 2012 Sep;188(3):851–855.
Journal cover image

Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

September 2012

Volume

188

Issue

3

Start / End Page

851 / 855

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Ureteral Obstruction
  • Treatment Outcome
  • Stents
  • Retrospective Studies
  • Prosthesis Design
  • Molybdenum
  • Male
  • Humans
  • Female