Buksh Omar, Jar Anfar, Khogeer Ahmad, Alzahrani Hani, Akram Rabea, Taher Mohammad, Al Akra'a Mahmoud, Alammari Adel, Junaid Islam
Department of Urology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
Urol Ann. 2024 Jan-Mar;16(1):98-103. doi: 10.4103/ua.ua_160_22. Epub 2024 Jan 25.
Double J (DJ) stent is widely used in cases of ureteric strictures as a temporary solution; however, it has certain limitations, such as the need for frequent exchange. Alternatively, a long-lasting thermoexpandable stent (Memokath™ 051) has been used to relieve ureteral obstructions in comorbid patients with multiple reported advantages, such as longer durability which avoids the need of frequent exchanges. In addition, it can be used in certain cases of urethral strictures. Our study is the first in the region to report the experience and outcome of Memokath stent with ureteral and urethral strictures.
After local IRB approval, we retrospectively reviewed records of 21 patients who underwent insertion of Memokath 051 stent in the ureter and Memokath 045 in the urethra between 2013 and 2021. Indications of insertion, indwelling duration, and causes of removal were collected and analyzed by SPSS.
Twenty-one patients received 21 Memokath stents for 11 ureteral strictures and 10 urethral strictures. Fifty-five percent of ureteral strictures were malignant, and 27.3% of the benign ureteric strictures were transplant ureters. Ureteric memokath stents remained functioning for a mean of 16.1 months. Mean indwelling time for transplant ureteric memokath stents was 24.3 months. Total 4 ureteric stents had migrated, 4 stents blocked, and 2 stents were removed as planned and 1 stent removed due to febrile urinary tract infection (UTI). Ten urethral stents remained in place for mean of 14 months. Three stents were removed as planned with resolution of stricture, two were removed due to blockage, three stents had UTI, one was removed due to pain, and one stent remained functioning until the patient expired.
Our outcome is comparable to other published studies, suggesting that ureteric Memokath stent is a better option with adequate indwelling time, especially in transplant ureters, in comparison with DJ stents. In addition, Memokath stents can be used in selected recurrent urethral strictures where surgical reconstruction is not feasible.
双J(DJ)支架作为一种临时解决方案,在输尿管狭窄病例中广泛应用;然而,它有一定局限性,比如需要频繁更换。另外,一种长效热膨胀支架(Memokath™ 051)已被用于缓解合并症患者的输尿管梗阻,有多项已报道的优势,如耐久性更长,无需频繁更换。此外,它可用于某些尿道狭窄病例。我们的研究是该地区首个报告Memokath支架用于输尿管和尿道狭窄的经验及结果的研究。
经当地机构审查委员会批准后,我们回顾性分析了2013年至2021年间21例行Memokath 051输尿管支架置入术及Memokath 045尿道支架置入术患者的记录。收集置入指征、留置时间及取出原因,并通过SPSS进行分析。
21例患者接受了21枚Memokath支架,其中11例为输尿管狭窄,10例为尿道狭窄。55%的输尿管狭窄为恶性,27.3%的良性输尿管狭窄为移植输尿管。输尿管Memokath支架平均保持功能16.1个月。移植输尿管Memokath支架平均留置时间为24.3个月。共有4枚输尿管支架移位,4枚堵塞,2枚按计划取出,1枚因发热性尿路感染(UTI)取出。10枚尿道支架平均留置14个月。3枚按计划取出,狭窄解除;2枚因堵塞取出;3枚发生UTI;1枚因疼痛取出;1枚在患者死亡前仍保持功能。
我们的结果与其他已发表研究相当,表明与DJ支架相比,输尿管Memokath支架留置时间足够,是更好的选择,尤其适用于移植输尿管。此外,Memokath支架可用于手术重建不可行的某些复发性尿道狭窄病例。