Comparison of single and tandem ureteral stenting for malignant ureteral obstruction: a prospective study of 104 patients

Eur Radiol. 2019 Feb;29(2):628-635. doi: 10.1007/s00330-018-5560-6. Epub 2018 Jul 4.

Abstract

Objectives: The aim of this study was to compare single and tandem ureteral stenting in the management of malignant ureteral obstruction (MUO).

Methods: Our hospital's institutional review board approved this prospective study. Between November 2014 and June 2017, single ureteral stenting was performed in 56 patients (94 renal units) and tandem ureteral stenting in 48 patients (63 renal units) for MUO. A comparative analysis of the technical success rate, patient survival, stent patency, and complications was performed.

Results: Similar demographic data were observed in patients receiving either single or tandem ureteral stenting. The technical success rate was 93.6% (88/94) for single ureteral stenting and 95.2% (60/63) for tandem ureteral stenting. There was no difference in overall survival between patients receiving single or tandem ureteral stenting (p = 0.41), but the duration of stent patency in tandem ureteral stenting was significantly longer (p = 0.022). The mean patency time was 176.7 ± 21.3 days for single ureteral stenting, and 214.7 ± 21.0 days for tandem ureteral stenting. The complications of ureteral stenting were urinary tract infection (n = 18), lower urinary tract symptoms (n = 5), haematuria (n = 3), and stent migration (n = 1).

Conclusions: Tandem ureteral stenting is a safe and feasible treatment for MUO, and had better efficacy compared to single ureteral stenting.

Key points: • Ureteral stenting is an established treatment for the management of malignant ureteral obstruction (MUO) • Prospective single-centre study showed that tandem ureteral stenting is a safe and feasible treatment for MUO • Tandem ureteral stenting provides longer stent patency compared to single ureteral stenting in patient with MUO.

Keywords: Humans; Hydronephrosis; Prospective studies; Stents; Ureteral obstruction.

Publication types

  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Female
  • Hematuria / etiology
  • Humans
  • Lower Urinary Tract Symptoms / etiology
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Palliative Care / methods
  • Prospective Studies
  • Stents* / adverse effects
  • Ultrasonography, Interventional / methods
  • Ureter
  • Ureteral Obstruction / diagnostic imaging
  • Ureteral Obstruction / etiology
  • Ureteral Obstruction / therapy*
  • Urinary Tract Infections / etiology