Wallstents for the treatment of extrinsic malignant ureteral obstruction: Midterm results

PURPOSE: To test the clinical efficacy of metal stents in the treatment of malignant ureteral obstruction and to maximize the effectiveness of the method. MATERIALS AND METHODS: Fifty-four malignant stenoses of the ureter were treated in 40 patients by implantation of a self-expandable permanent endoluminal stent (SPES). RESULTS: The mean follow-up time was 10.5 months (range, 1-44 months). Recanalization was possible in all but one ureter. Fifty-one ureters were kept sufficiently open during the follow-up period. Fifty-one percent needed no further intervention, whereas 49% needed reintervention to reestablish patency. Three ureters in the latter group finally had to be abandoned. The primary patency after 12 months was 31% according to the Kaplan-Meier estimation. The survival rates of the patients were 40% after 12 months and 22% after 24 months and were unrelated to stent placement. CONCLUSION: Since no major complications occurred and hydronephrosis and its sequelae could be prevented in most cases during the observation period, the authors conclude that the implantation of a SPES into the ureter is a safe and effective method for the palliative treatment of tumor-associated ureteral strictures.