Metallic Full-Length Ureteral Stents: Does Urinary Tract Infection Cause Obstruction?

Metallic ureteral stents promise to offer superior upper urinary tract drainage with extended exchange intervals and freedom from extrinsic compression in patients with advanced malignancy or other significant obstructing retroperitoneal or pelvic processes. Existing literature indicates a variable...

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Main Authors: James A. Brown, Christopher L. Powell, Kristopher R. Carlson
Format: Article
Language:English
Published: Wiley 2010-01-01
Series:The Scientific World Journal
Online Access:http://dx.doi.org/10.1100/tsw.2010.162
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author James A. Brown
Christopher L. Powell
Kristopher R. Carlson
author_facet James A. Brown
Christopher L. Powell
Kristopher R. Carlson
author_sort James A. Brown
collection DOAJ
description Metallic ureteral stents promise to offer superior upper urinary tract drainage with extended exchange intervals and freedom from extrinsic compression in patients with advanced malignancy or other significant obstructing retroperitoneal or pelvic processes. Existing literature indicates a variable experience with these relatively new devices, with some investigators reporting excellent results and long problem-free intervals, and others reporting less enthusiastic outcomes. We report a retrospective review of a series of five sequential patients undergoing placement of Resonance® (Cook Medical, Bloomington, IN) metallic ureteral stents for extrinsic ureteral compression refractory to placement of traditional (polymer) ureteral stents. Of five patients reviewed, three (60%) required additional operative intervention for stent migration or malposition. Four patients (80%) died of their primary malignancy <12 months after metallic stent placement. Four (80%) of five patients had obstruction of their stents demonstrated with nuclear renography and/or other imaging, and three (60%) required removal and alternative means of urinary tract drainage within 4 months of placement due to obstruction, intractable pain, or migration. Four patients (80%) had urinary tract infections (UTIs) within 4 months of stent placement. No obstruction was seen due to extrinsic ureteral compression after stent placement. Metallic ureteral stents may have utility for patients with pathological processes causing extrinsic ureteral compression refractory to the use of traditional polymer ureteral stents. However, metallic ureteral stents are not immune to obstruction, migration, and associated discomfort. Stent obstruction appears to be increased in patients with postoperative UTI.
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spelling doaj-art-a4b33ce09e654151a0145289859a4b3e2025-02-03T06:00:09ZengWileyThe Scientific World Journal1537-744X2010-01-01101566157310.1100/tsw.2010.162Metallic Full-Length Ureteral Stents: Does Urinary Tract Infection Cause Obstruction?James A. Brown0Christopher L. Powell1Kristopher R. Carlson2Department of Surgery, Division of Urology, Medical College of Georgia Hospitals and Clinics, Augusta, GA, USADepartment of Surgery, Division of Urology, Medical College of Georgia Hospitals and Clinics, Augusta, GA, USADepartment of Surgery, Division of Urology, Medical College of Georgia Hospitals and Clinics, Augusta, GA, USAMetallic ureteral stents promise to offer superior upper urinary tract drainage with extended exchange intervals and freedom from extrinsic compression in patients with advanced malignancy or other significant obstructing retroperitoneal or pelvic processes. Existing literature indicates a variable experience with these relatively new devices, with some investigators reporting excellent results and long problem-free intervals, and others reporting less enthusiastic outcomes. We report a retrospective review of a series of five sequential patients undergoing placement of Resonance® (Cook Medical, Bloomington, IN) metallic ureteral stents for extrinsic ureteral compression refractory to placement of traditional (polymer) ureteral stents. Of five patients reviewed, three (60%) required additional operative intervention for stent migration or malposition. Four patients (80%) died of their primary malignancy <12 months after metallic stent placement. Four (80%) of five patients had obstruction of their stents demonstrated with nuclear renography and/or other imaging, and three (60%) required removal and alternative means of urinary tract drainage within 4 months of placement due to obstruction, intractable pain, or migration. Four patients (80%) had urinary tract infections (UTIs) within 4 months of stent placement. No obstruction was seen due to extrinsic ureteral compression after stent placement. Metallic ureteral stents may have utility for patients with pathological processes causing extrinsic ureteral compression refractory to the use of traditional polymer ureteral stents. However, metallic ureteral stents are not immune to obstruction, migration, and associated discomfort. Stent obstruction appears to be increased in patients with postoperative UTI.http://dx.doi.org/10.1100/tsw.2010.162
spellingShingle James A. Brown
Christopher L. Powell
Kristopher R. Carlson
Metallic Full-Length Ureteral Stents: Does Urinary Tract Infection Cause Obstruction?
The Scientific World Journal
title Metallic Full-Length Ureteral Stents: Does Urinary Tract Infection Cause Obstruction?
title_full Metallic Full-Length Ureteral Stents: Does Urinary Tract Infection Cause Obstruction?
title_fullStr Metallic Full-Length Ureteral Stents: Does Urinary Tract Infection Cause Obstruction?
title_full_unstemmed Metallic Full-Length Ureteral Stents: Does Urinary Tract Infection Cause Obstruction?
title_short Metallic Full-Length Ureteral Stents: Does Urinary Tract Infection Cause Obstruction?
title_sort metallic full length ureteral stents does urinary tract infection cause obstruction
url http://dx.doi.org/10.1100/tsw.2010.162
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AT kristopherrcarlson metallicfulllengthureteralstentsdoesurinarytractinfectioncauseobstruction