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A systematic review of long-duration stents for ureteral stricture: which one to choose?

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Abstract

Objective

To define which long-term stent would work best in malignant ureteral obstruction (MUO) and benign ureteral obstruction (BUO), focusing on their mechanisms of action, price and insertion approach.

Methods

A systematic review was developed using the MEDLINE and Scopus databases and in accordance with the PRISMA checklist. There were no language restrictions for the search. Studies describing the use of metallic ureteric stents for MUO and for BUO in humans were included.

Results

We analyzed five types of metallic stents (35 papers) and also the experience with the tumor and extra-anatomical stents. The Resonance, Memokath and Allium ureteral stents were found to be useful in BUO and MUO. The Uventa stent performed well in chronic ureteral obstruction. The Detour bypass stent was a recommended option in those patients who had complete obstruction of the ureter and were unfit for reconstructive surgery.

There was no difference with regard to the insertion technique and both antegrade and retrograde approaches were equally successful. Although tumor stents showed a good performance, there were very few published studies on it.

Conclusion

Metallic stents are a suitable option for MUO and BUO. When compared to standard double J stents, although they are relatively high priced, they show a financial benefit in the long-term. The Detour bypass stent seems to be an effective alternative for complete ureteral obstruction or patients unfit for surgery. Further prospective randomized studies should be done on the effectiveness of tumor stents versus metallic stents.

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Funding

This is an independent study and is not funded by any external body. Prof. Olivier Traxer is a consultant for Coloplast, Rocamed, Olympus, EMS, Boston Scientific and IPG.

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Authors and Affiliations

  1. GRC Urolithiasis no. 20, Tenon Hospital, Sorbonne University, 75020, Paris, France

    Mariela Corrales, Steeve Doizi, Yazeed Barghouthy, Hatem Kamkoum & Olivier Traxer

  2. Department of Urology AP-HP, Tenon Hospital, Sorbonne University, 75020, Paris, France

    Mariela Corrales, Steeve Doizi, Yazeed Barghouthy, Hatem Kamkoum & Olivier Traxer

  3. University Hospital Southampton NHS Trust, Southampton, UK

    Bhaskar Somani

Authors
  1. Mariela Corrales
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  2. Steeve Doizi
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  4. Hatem Kamkoum
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  5. Bhaskar Somani
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  6. Olivier Traxer
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Contributions

MC: Project development, data collection, manuscript writing. SD, YB, HK: Data analysis. OT, BKS: Project development, data collection, manuscript editing.

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Correspondence to Olivier Traxer.

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Corrales, M., Doizi, S., Barghouthy, Y. et al. A systematic review of long-duration stents for ureteral stricture: which one to choose?. World J Urol 39, 3197–3205 (2021). https://doi.org/10.1007/s00345-020-03544-x

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  • DOI: https://doi.org/10.1007/s00345-020-03544-x

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