Division of Urology, Southern Illinois University School of Medicine, Springfield, Illinois 62794-9665, USA.
J Urol. 2011 Jun;185(6):2217-22. doi: 10.1016/j.juro.2011.02.008. Epub 2011 Apr 17.
Metal ureteral stents are a relatively new version of a device with a long history of relieving ureteral obstruction. Metal stents are effective for relieving ureteral obstruction but success regarding patient tolerability has been variable. We present our single institution experience with long-term metal ureteral stent placement.
The charts of patients undergoing metal ureteral stent placement for chronic ureteral obstruction were reviewed. Data collected included patient age, gender, diagnosis/cause of obstruction, laterality, duration of indwelling metal stent, number of routine metal stent changes, complications and early discontinuations or stent changes.
A total of 23 patients underwent placement of metal ureteral stents between February 2008 and September 2010. Bilateral stents were placed in 5 patients and 9 underwent a yearly metal stent exchange for a total of 42 ureteral units treated with metal ureteral stents. All metal stents were placed to relieve ureteral obstruction due to ureteral stricture, ureteropelvic junction obstruction, retroperitoneal fibrosis or extrinsic malignant obstruction. There were 3 metal stent failures in 2 patients with malignant ureteral obstruction. There were no complications, or early discontinuations or changes due to adverse symptoms, patient dissatisfaction, worsening renal function or progressive hydronephrosis.
Metal ureteral stents are effective for benign and malignant ureteral obstruction in the absence of urolithiasis. Good tolerability and annual stent exchange make metal stents an appealing alternative for patients with chronic ureteral obstruction treated with indwelling ureteral stents.
金属输尿管支架是一种具有悠久历史的缓解输尿管梗阻的设备的相对较新的版本。金属支架在缓解输尿管梗阻方面是有效的,但在患者耐受性方面的成功率却各不相同。我们介绍了我们单机构使用长期金属输尿管支架置入术的经验。
对因慢性输尿管梗阻而接受金属输尿管支架置入术的患者的病历进行了回顾。收集的数据包括患者年龄、性别、梗阻的诊断/原因、侧别、留置金属支架的时间、常规金属支架更换的次数、并发症以及早期终止或支架更换。
2008 年 2 月至 2010 年 9 月期间,共有 23 例患者接受了金属输尿管支架置入术。5 例患者双侧放置支架,9 例患者每年更换一次金属支架,共治疗 42 个输尿管单位。所有金属支架均放置在因输尿管狭窄、肾盂输尿管交界处梗阻、腹膜后纤维化或外源性恶性梗阻而导致输尿管梗阻的患者中。2 例恶性输尿管梗阻患者中有 3 例金属支架失败。由于不良症状、患者不满、肾功能恶化或进行性肾积水导致无并发症、早期终止或因不良反应而改变。
在没有尿路结石的情况下,金属输尿管支架对良性和恶性输尿管梗阻均有效。良好的耐受性和每年的支架更换使金属支架成为慢性输尿管梗阻患者留置输尿管支架治疗的一种有吸引力的替代方案。