Multicenter experience of the newly designed covered metallic ureteral stent for malignant ureteral occlusion: comparison with double J stent insertion.

Abstract

PURPOSE: This study was designed to evaluate the effectiveness of the newly

designed covered metallic stent (CMS) for malignant ureteral obstruction by

comparing with double J stent (DJS). MATERIAL AND METHODS: CMSs were placed for

malignant ureteral obstruction caused by various types of cancers for 42 ureters

in 32 patients from 7 institutes. Retrospective data were collected for DJSs,

which included 72 malignant ureteral occlusions in 56 patients from a single

institute. Twenty-seven DJSs were placed percutaneously, and 45 DJSs were

cystoscopically inserted. Technical failure of the CMS group was compared with

that of the radiologically inserted DJS group. Primary patency of the CMS group

was compared with assisted primary patency of the DJS group. RESULTS: Technical

failure of the CMS group is lower than that of the radiologically inserted DJS

group: 0% (0/42) vs. 25.9% (7/27; p = 0.002), respectively. Primary patency of

the CMS group is better than assisted primary patency of the DJS group (p =

0.012). Primary patency of the CMSs is 100, 94.5, 74.7, 70.3, 65.3, 65.3, and

65.3% at 1, 3, 6, 9, 12, 18, and 24 months, respectively. Assisted primary

patency of the DJS is 78.6, 75.1, 59.1, 48.7, 38.7, and 37.8% at 1, 3, 6, 9, 12,

and 18 months, respectively. No serious complications were noted in the CMS

group. Migration of the metallic stent occurred in one patient (2.3%).

CONCLUSIONS: Covered metallic stent placement for malignant ureteral obstruction

is superior to the double J stent placement in terms of technical success and

patency.