Covered Metal Ureteral Stents in the Maintenance Treatment of Refractory Ureteral Stricture: A Prospective, Multi-Center, and Large-Scale Cohort Study with 3-Year Outcomes
Year: 2025
Type: article
Abstract: Introduction: Covered metal ureteral stents (CMUSs) have shown promising results for ureteral stricture. However, 3-year outcomes of CMUSs are lacking. This study aimed to evaluate the 3-year efficacy and safety of CMUSs in the maintenance treatment of refractory ureteral stricture (RUS) and explore risk factors for CMUSs-related complications. Methods: Between August 2018 and July 2021, 321 patients (366 renal ureter units [RUUs]) with RUS who underwent CMUSs implantation surgery were prospectively recruited in this study. A regular 3-year follow-up protocol including serum biochemistry test, abdominal imaging, and ureteral stent syndrome questionnaire was established to analyze ureteral patency and patient’s quality of life (QoL). The primary ureteral patency was defined as patent ureters without CMUSs-related complications, while secondary ureteral patency also included those that restored patent after endoscopic interventions. Results: The study included 105 (32.7%) patients with stone-related benign ureteral stricture (BUS), 90 (28.0%) with nonstone-related BUS, 76 (23.7%) with radiation-induced ureteral stricture (RIUS), and 50 (15.6%) with malignant ureteral stricture. There existed significant differences in mean serum creatinine levels and renal pelvis widths before and after CMUSs implantation (all p < 0.001). Patients’ QoL significantly improved at postoperative 12 and 36 months (both p < 0.001). CMUSs-related complications occurred in 95 (26.0%) RUUs, including 24 (6.6%) with end-stent ureteral restenosis, 28 (7.7%) with stent migration, 31 (8.5%) with stent encrustation, 7 (1.9%) with infection, and 5 (1.4%) with ureteral fistula. The 3-year primary and secondary ureteral patency rate was 74.0% and 90.4%, respectively. However, among patients with RIUS, the primary and secondary ureteral patency rates were only 54.7% and 77.4%, respectively. Conclusion: CMUSs are effective and safe in the 3-year maintenance treatment of RUS. Patients with CMUSs experience long-term improved QoL. However, patients who underwent radiotherapy are susceptible to developing CMUSs-related complications.
Source: Journal of Endourology
Authors: Mingrui Wang, Rui Zhu, Shicong Lai, Haopu Hu, Yong Zhang, Wenmin Dong, Yigang Zuo, Xianzhong Duan, Wenzeng Yang, Fenghong Cao, Kailong Liu, Hongyao Liu, Xiangyu Che, Weixing Qu, Kexin Xu, Guibin Xu, Tao Xu, Hao Hu
Institutions: Peking University, Peking University People's Hospital, Guangzhou Medical University, Capital Medical University, Beijing Tian Tan Hospital, Kunming Medical University, Affiliated Hospital of Hebei University, North China University of Science and Technology Affiliated Hospital, Second Hospital of Hebei Medical University, First Affiliated Hospital of Dalian Medical University, Shaanxi Provincial People's Hospital
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4414160278