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  • Title: Ureteral obstruction: is the full metallic double-pigtail stent the way to go?
    Author: Liatsikos E, Kallidonis P, Kyriazis I, Constantinidis C, Hendlin K, Stolzenburg JU, Karnabatidis D, Siablis D.
    Journal: Eur Urol; 2010 Mar; 57(3):480-6. PubMed ID: 19232816.
    Abstract:
    BACKGROUND: The Resonance metallic ureteral stent (Cook Medical, Bloomington, Indiana, USA) has been introduced for the management of extrinsic-etiology ureteral obstruction for time periods up to 12 mo. OBJECTIVE: The current study aims to determine short- and medium-term effectiveness of the Resonance stent in malignant and benign ureteral obstruction. DESIGN, SETTING, AND PARTICIPANTS: In total, 50 patients with extrinsic malignant obstruction (n=25), benign ureteral obstruction (n=18), and previously obstructed mesh metal stents (n=7) were prospectively evaluated. INTERVENTION: All patients were treated by Resonance stent insertion. Twenty stents were inserted in antegrade fashion, and the remaining stents were inserted in a retrograde approach. No patient dropped out of the study. The follow-up evaluation included biochemical and imaging modalities. MEASUREMENTS: We evaluated the technical success rate, stricture patency rate, complications, and the presence and type of encrustation. RESULTS AND LIMITATIONS: The technical success rate of transversal and stenting of the strictures was 100%. In 19 patients, balloon dilatation was performed prior to stenting. The mean follow-up period was 8.5 mo. The stricture patency rate in patients with extrinsic malignant ureteral obstruction was 100% and in patients with benign ureteral obstruction 44%. Failure of Resonance stents in all cases of obstructed metal stents was observed shortly after the procedure (2-12 d). In nine cases, stent exchange was demanding. Encrustation was present in 12 out of 54 stents. CONCLUSIONS: The Resonance stent provides safe and sufficient management of malignant extrinsic ureteral obstruction. Resonance stent use in benign disease needs further evaluation, considering the untoward results of the present study.
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