Open Access

ARTICLE

Wire-reinforced ureteral stents to rescue from nephrostomy tube in extrinsic ureteral obstruction

Casey A. Dauw, Gary J. Faerber, John M. Hollingsworth, III, J. Stuart Wolf, Jr.

Department of Urology, University of Michigan Health System, Ann Arbor, Michigan, USA
Address correspondence to Dr. J. Stuart Wolf, Jr., Department of Urology, University of Michigan, 3875 Taubman Center, 1500 East Medical Center Dr. Ann Arbor, MI 48109-0330 USA

Canadian Journal of Urology 2015, 22(3), 7806-7810.

Abstract

Introduction: Ureteral obstruction due to extrinsic compression is associated with significant morbidity and mortality. Management options for this condition include renal drainage with percutaneous nephrostomy (PCN) or internal ureteral stent placement. A significant portion of patients will have disease progression leading to internal stent obstruction which is almost uniformly managed with PCN. We evaluated a novel, wire-reinforced internal ureteral stent as an alternative to PCN in those patients who fail initial internal ureteral stent placement.
Materials and methods: A retrospective chart review was performed to identify patients with extrinsic ureteral obstruction that failed conventional plastic internal ureteral stent placement and ultimately underwent placement of wire-reinforced internal ureteral stents (Scaffold) at the University of Michigan Health System between 2006-2011. Outcomes assessed included time to Scaffold stent failure and failure free time with Scaffold stent in place.
Results: A total of 8 patients were identified with extrinsic ureteral obstruction that failed initial conventional ureteral stenting and had a Scaffold stent placed. Scaffold stents ultimately failed in 3 out of 8 patients. Mean time to Scaffold stent failure was 197 days (range 20-536). In the remaining 5 patients, mean failure-free time with Scaffold stents in place was 277 days (range 18-774).
Conclusion: Scaffold stent placement is a viable alternative to PCN in those patients with extrinsic ureteral obstruction who fail conventional internal ureteral stent placement.

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