Effectiveness of Double-J Metallic Mesh Ureteral Stents for Malignant Ureteral Obstruction: A Retrospective Study

Abstract

Background/aim: Malignant ureteral obstruction is associated with high rates of failure with traditional ureteral stents. Double-J metallic mesh ureteral stent is one of the latest options for treating malignant ureteral obstruction. However, data regarding the efficacy of using this stent in this context are limited. Thus, we retrospectively investigated the efficacy of this stent.

Patients and methods: We retrospectively analyzed the records of all patients who required double-J metallic mesh ureteral stent placement for malignant ureteral obstruction at Ishikawa Prefectural Central Hospital (Kanazawa, Japan) between October 2018 and April 2022. Primary stent patency was defined as complete or partial resolution of hydronephrosis as shown by imaging studies or successful removal of a preexisting nephrostomy tube. Stent failure was defined as unplanned stent exchange or nephrostomy tube placement for signs or symptoms of recurrent ureteral obstruction. A competing risk model was used to estimate the cumulative incidence of stent failure.

Results: Double-J metallic mesh ureteral stents were placed in 63 ureters of 44 patients (13 males, 31 females). The median age of patients was 67 years (range=37-92 years). There was no grade 3 or higher complications. The overall primary patency rate was 95% (60 ureters). Stent failure occurred in seven patients (11%) during follow-up. The cumulative incidence of stent failure at 12 months after placement was 17.3%.

Conclusion: Double-J metallic mesh ureteral stent is a safe, simple, and promising treatment option for malignant ureteral obstruction.

Keywords: Metallic; survival; ureter; ureteral obstruction; ureteral stents.