Safety and Efficacy of Double-J Metallic Mesh Ureteral Stents in Malignant Ureteral Obstruction

双J型金属网状输尿管支架治疗恶性输尿管梗阻的安全性和有效性

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Abstract

INTRODUCTION: The mortality rate of malignant ureteral obstruction (MUO) is high, and ureteral stents are widely used for its treatment. Polymeric ureteral stents are commonly utilized, but stent occlusion due to tumor obstruction poses a problem. Conversely, metallic ureteral stents, while pressure resistant, can cause significant pain during insertion and replacement, often necessitating anesthesia. Since 2017, double-J metallic mesh ureteral stents have been on the market, but reports on their efficacy and safety are still limited. We collected data on using this stent at our hospital and conducted an analysis and evaluation to report our findings. METHODOLOGY: We retrospectively studied 23 cases in which stainless mesh ureteral stents were inserted at our hospital from April 2023 to December 2024. RESULTS: A total of 29 ureters were stented in 23 cases (14 females and 9 males). The mean age was 69 years (range = 46-81 years), with primary diseases including gynecological cancer in 11 cases, gastrointestinal cancer in seven cases, urological cancer in four cases, and one case of retroperitoneal fibrosis. Four cases required stent replacement due to stent failure during the observation period. The mean follow-up period was 400 days, during which eight cases died due to the primary disease. CONCLUSIONS: We examined the use of double-J metallic mesh ureteral stents at our hospital. The stents showed high utility for MUO. Furthermore, our findings suggest that they may reduce the burden on both physicians and patients, as they potentially eliminate the need for frequent replacements compared to polymeric ureteral stents, which typically require replacement every three months.

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