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Advances in Ureteral Stents in the Maintenance Therapeutic of Malignant Ureteral Stricture

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Abstract

Malignant ureteral stricture is caused by ureteral compression by tumor invasion or tumor metastasis to the retroperitoneum, and upper urinary tract symptoms are caused by tumor factors. Imaging examination revealed hydroureter and hydronephrosis, which may lead to renal region pain and upper urinary tract infections, even renal failure. Severity of the disease could lead to the death of the patient. Patients with malignant ureteral strictures have worse prognosis and less survival time. Clinically, there are no relevant guidelines for the diagnosis and management of malignant ureteral strictures, and diversified therapy procedures exist, yet none of them are the most suitable. Most malignant ureteral stricture patients do not tolerate open surgery. With the development and continuously maturing of endoluminal techniques, the use of minimally invasive surgery has also become more mature; more therapy options are expected to have improved over time for malignant ureteral stricture patients. The use of ureteric stents is common in the treatment of benign or malignant ureteric strictures because the features of good durability facilitate urine drainage and structurally support the vascular wall. This review article will be based on advances in ureteral stents in the maintenance therapeutic of malignant ureteral strictures.

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Data Availability

The data presented in this study are available on reasonable request from the corresponding author.

References

  1. Kurata S, Tobu S, Udo K et al (2017) Outcomes of ureteral stent placement for hydronephrosis in patients with gynecological malignancies[J]. Curr Urol 10(3):126–131. https://doi.org/10.1159/000447165

    Article  PubMed  PubMed Central  Google Scholar 

  2. Hsu L, Li H, Pucheril D et al (2016) Use of percutaneous nephrostomy and ureteral stenting in management of ureteral obstruction[J]. World J Nephrol 5(2):172–181. https://doi.org/10.5527/wjn.v5.i2.172

    Article  PubMed  PubMed Central  Google Scholar 

  3. Tyritzis SI, Wiklund NP (2015) Ureteral strictures revisited…trying to see the light at the end of the tunnel: a comprehensive review[J]. J Endourol 29(2):124–136. https://doi.org/10.1089/end.2014.0522

    Article  PubMed  Google Scholar 

  4. Vogt B, Blanchet LH (2021) 10-year experience with reinforced ureteral stents for malignant ureteral obstruction[J]. Res Rep Urol 13:581–589. https://doi.org/10.2147/RRU.S326274

    Article  PubMed  PubMed Central  Google Scholar 

  5. Cordeiro MD, Coelho RF, Chade DC et al (2016) A prognostic model for survival after palliative urinary diversion for malignant ureteric obstruction: a prospective study of 208 patients[J]. BJU Int 117(2):266–271. https://doi.org/10.1111/bju.12963

    Article  PubMed  Google Scholar 

  6. Miller KD, Siegel RL, Lin CC et al (2016) Cancer treatment and survivorship statistics, 2016[J]. CA Cancer J Clin 66(4):271–289. https://doi.org/10.3322/caac.21349

    Article  PubMed  Google Scholar 

  7. Yoon JH, Park S, Park S et al (2018) Renal function is associated with prognosis in stent-change therapy for malignant ureteral obstruction[J]. Investig Clin Urol 59(6):376–382. https://doi.org/10.4111/icu.2018.59.6.376

    Article  PubMed  PubMed Central  Google Scholar 

  8. Maguire PJ, Sobota A, Mulholland D et al (2020) Incidence, management, and sequelae of ureteric obstruction in women with cervical cancer[J]. Support Care Cancer 28(2):725–730. https://doi.org/10.1007/s00520-019-04851-9

    Article  PubMed  Google Scholar 

  9. O’Connor EM, Nason GJ, Kiely EA (2017) Urological management of extramural malignant ureteric obstruction: a survey of Irish urologists[J]. Curr Urol 11(1):21–25. https://doi.org/10.1159/000447190

    Article  PubMed  PubMed Central  Google Scholar 

  10. Zimskind PD, Fetter TR, Wilkerson JL (1967) Clinical use of long-term indwelling silicone rubber ureteral splints inserted cystoscopically[J]. J Urol 97(5):840–844. https://doi.org/10.1016/s0022-5347(17)63130-6

    Article  CAS  PubMed  Google Scholar 

  11. Rosevear HM, Kim SP, Wenzler DL et al (2007) Retrograde ureteral stents for extrinsic ureteral obstruction: nine years’ experience at University of Michigan[J]. Urology 70(5):846–850. https://doi.org/10.1016/j.urology.2007.07.008

    Article  PubMed  Google Scholar 

  12. Wang Y, Wang G, Hou P et al (2015) Subcutaneous nephrovesical bypass: treatment for ureteral obstruction in advanced metastatic disease[J]. Oncol Lett 9(1):387–390. https://doi.org/10.3892/ol.2014.2679

    Article  PubMed  Google Scholar 

  13. Shekarriz B, Shekarriz H, Upadhyay J et al (1999) Outcome of palliative urinary diversion in the treatment of advanced malignancies[J]. Cancer 85(4):998–1003. https://doi.org/10.1002/(sici)1097-0142(19990215)85:4%3c998::aid-cncr30%3e3.0.co;2-f

    Article  CAS  PubMed  Google Scholar 

  14. Chung SY, Stein RJ, Landsittel D et al (2004) 15-year experience with the management of extrinsic ureteral obstruction with indwelling ureteral stents[J]. J Urol 172(2):592–595. https://doi.org/10.1097/01.ju.0000130510.28768.f5

    Article  PubMed  Google Scholar 

  15. Yossepowitch O, Lifshitz DA, Dekel Y et al (2001) Predicting the success of retrograde stenting for managing ureteral obstruction[J]. J Urol 166(5):1746–1749. https://doi.org/10.1097/00005392-200111000-00029

    Article  CAS  PubMed  Google Scholar 

  16. Wang JY, Zhang HL, Zhu Y et al (2016) Predicting the failure of retrograde ureteral stent insertion for managing malignant ureteral obstruction in outpatients[J]. Oncol Lett 11(1):879–883. https://doi.org/10.3892/ol.2015.3961

    Article  PubMed  Google Scholar 

  17. Ganatra AM, Loughlin KR (2005) The management of malignant ureteral obstruction treated with ureteral stents[J]. J Urol 174(6):2125–2128. https://doi.org/10.1097/01.ju.0000181807.56114.b7

    Article  PubMed  Google Scholar 

  18. Izumi K, Mizokami A, Maeda Y et al (2011) Current outcome of patients with ureteral stents for the management of malignant ureteral obstruction[J]. J Urol 185(2):556–561. https://doi.org/10.1016/j.juro.2010.09.102

    Article  PubMed  Google Scholar 

  19. Goldsmith ZG, Wang AJ, Bañez LL et al (2012) Outcomes of metallic stents for malignant ureteral obstruction[J]. J Urol 188(3):851–855. https://doi.org/10.1016/j.juro.2012.04.113

    Article  PubMed  Google Scholar 

  20. Wenzler DL, Kim SP, Rosevear HM et al (2008) Success of ureteral stents for intrinsic ureteral obstruction[J]. J Endourol 22(2):295–299. https://doi.org/10.1089/end.2007.0201

    Article  PubMed  Google Scholar 

  21. Ohtaka M, Kawahara T, Takamoto D et al (2018) Gastrointestinal cancer and bilateral hydronephrosis resulted in a high risk of ureteral stent failure[J]. BMC Urol 18(1):35. https://doi.org/10.1186/s12894-018-0346-3

    Article  PubMed  PubMed Central  Google Scholar 

  22. Matsuura H, Arase S, Hori Y (2019) Ureteral stents for malignant extrinsic ureteral obstruction: outcomes and factors predicting stent failure[J]. Int J Clin Oncol 24(3):306–312. https://doi.org/10.1007/s10147-018-1348-6

    Article  CAS  PubMed  Google Scholar 

  23. Kim SH, Park B, Joo J et al (2017) Retrograde pyelography predicts retrograde ureteral stenting failure and reduces unnecessary stenting trials in patients with advanced non-urological malignant ureteral obstruction[J]. PLoS One 12(9):e0184965. https://doi.org/10.1371/journal.pone.0184965

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Matsuura H, Arase S, Hori Y (2020) Clinical outcomes and prognostic factors associated with internal ureteral stent placement for malignant extrinsic ureteral obstruction[J]. Support Care Cancer 28(12):5743–5750. https://doi.org/10.1007/s00520-020-05413-0

    Article  PubMed  Google Scholar 

  25. Elsamra SE, Motato H, Moreira DM et al (2013) Tandem ureteral stents for the decompression of malignant and benign obstructive uropathy[J]. J Endourol 27(10):1297–1302. https://doi.org/10.1089/end.2013.0281

    Article  PubMed  Google Scholar 

  26. Savin Z, Herzberg H, Ben-David R et al (2021) Long-term follow-up of yearly replaced double internal stents for extrinsic malignant ureteral obstruction[J]. J Endourol 35(1):71–76. https://doi.org/10.1089/end.2020.0469

    Article  PubMed  Google Scholar 

  27. Haifler M, Shvero A, Zilberman D et al (2020) Tandem ureteral stents for malignant ureteral obstruction[J]. J Endourol 34(2):222–226. https://doi.org/10.1089/end.2019.0685

    Article  PubMed  Google Scholar 

  28. Varnavas M, Bolgeri M, Mukhtar S et al (2016) The role of tandem double-J ureteral stents in the management of malignant ureteral obstruction[J]. J Endourol 30(4):465–468. https://doi.org/10.1089/end.2015.0670

    Article  PubMed  Google Scholar 

  29. Liu KL, Lee BC, Ye JD et al (2019) Comparison of single and tandem ureteral stenting for malignant ureteral obstruction: a prospective study of 104 patients[J]. Eur Radiol 29(2):628–635. https://doi.org/10.1007/s00330-018-5560-6

    Article  PubMed  Google Scholar 

  30. Monsky WL, Molloy C, Jin B et al (2013) Quality-of-life assessment after palliative interventions to manage malignant ureteral obstruction[J]. Cardiovasc Intervent Radiol 36(5):1355–1363. https://doi.org/10.1007/s00270-013-0571-9

    Article  PubMed  PubMed Central  Google Scholar 

  31. Ku JH, Lee SW, Jeon HG et al (2004) Percutaneous nephrostomy versus indwelling ureteral stents in the management of extrinsic ureteral obstruction in advanced malignancies: are there differences?[J]. Urology 64(5):895–899. https://doi.org/10.1016/j.urology.2004.06.029

    Article  PubMed  Google Scholar 

  32. Guachetá-Bomba PL, Echeverría-García F, García-Perdomo HA (2021) Predictors for failure of endoscopic ureteric stenting in patients with malignant ureteric obstruction: systematic review and meta-analysis[J]. BJU Int 127(3):292–299. https://doi.org/10.1111/bju.15237

    Article  PubMed  Google Scholar 

  33. Donat SM, Russo P (1996) Ureteral decompression in advanced nonurologic malignancies[J]. Ann Surg Oncol 3(4):393–399. https://doi.org/10.1007/bf02305670

    Article  CAS  PubMed  Google Scholar 

  34. Hao P, Li W, Song C et al (2008) Clinical evaluation of double-pigtail stent in patients with upper urinary tract diseases: report of 2685 cases[J]. J Endourol 22(1):65–70. https://doi.org/10.1089/end.2007.0114

    Article  PubMed  Google Scholar 

  35. Newton MR, Brown JA (2011) Full-length metallic double J stents: a review of Resonance® stents[J]. Clin Med Insights: Urol 5:S6604. https://doi.org/10.4137/CMU.S6604

    Article  Google Scholar 

  36. Azizi A, Pasticier G, Bénard A et al (2012) Tolerance and effectiveness of Memokath® 051 ureteral stents: a prospective 3 year follow-up study[J]. Prog Urol 22(5):266–272. https://doi.org/10.1016/j.purol.2012.01.002

    Article  CAS  PubMed  Google Scholar 

  37. Agrawal S, Brown CT, Bellamy EA et al (2009) The thermo-expandable metallic ureteric stent: an 11-year follow-up[J]. BJU Int 103(3):372–376. https://doi.org/10.1111/j.1464-410X.2008.08018.x

    Article  PubMed  Google Scholar 

  38. Chow PM, Hsu JS, Huang CY et al (2014) Metallic ureteral stents in malignant ureteral obstruction: clinical factors predicting stent failure[J]. J Endourol 28(6):729–734. https://doi.org/10.1089/end.2013.0792

    Article  PubMed  Google Scholar 

  39. Liatsikos E, Kallidonis P, Kyriazis I et al (2010) Ureteral obstruction: is the full metallic double-pigtail stent the way to go?[J]. Eur Urol 57(3):480–486. https://doi.org/10.1016/j.eururo.2009.02.004

    Article  PubMed  Google Scholar 

  40. Asakawa J, Iguchi T, Tamada S et al (2018) Outcomes of indwelling metallic stents for malignant extrinsic ureteral obstruction[J]. Int J Urol 25(3):258–262. https://doi.org/10.1111/iju.13500

    Article  PubMed  Google Scholar 

  41. Miyazaki J, Onozawa M, Takahashi S et al (2019) The Resonance ® metallic ureteral stent in the treatment of malignant ureteral obstruction: a prospective observational study[J]. BMC Urol 19(1):137. https://doi.org/10.1186/s12894-019-0569-y

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Kang Q, Jiang F, Yu Y et al (2018) Application of resonance metallic stents for malignant ureteral obstruction[J]. Minim Invasive Ther Allied Technol 27(6):333–338. https://doi.org/10.1080/13645706.2018.1443944

    Article  PubMed  Google Scholar 

  43. Chen Y, Liu CY, Zhang ZH et al (2019) Malignant ureteral obstruction: experience and comparative analysis of metallic versus ordinary polymer ureteral stents[J]. World J Surg Oncol 17(1):74. https://doi.org/10.1186/s12957-019-1608-6

    Article  PubMed  PubMed Central  Google Scholar 

  44. Moskovitz B, Halachmi S, Nativ O (2012) A new self-expanding, large-caliber ureteral stent: results of a multicenter experience[J]. J Endourol 26(11):1523–1527. https://doi.org/10.1089/end.2012.0279

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Baoding No.1 Central Hospital, Changcheng North Street and Number 320, Baoding, 071000, Hebei, China

    Liang Liu & Qiang Wang

  2. Prostate & Andrology Key Laboratory of Baoding, Changcheng North Street and Number 320, Baoding, 071000, Hebei, China

    Liang Liu & Qiang Wang

  3. Psychosomatic Medical Center, The Fourth People’s Hospital of Chengdu, Chengdu, 610036, Sichuan, China

    Yu Xiao

  4. Psychosomatic Medical Center, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 610036, Sichuan, China

    Yu Xiao

  5. Department of Urology, Hebei General Hospital, 348 West Heping Road, Shijiazhuang, 050051, Hebei, China

    Fu-zhen Sun

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  4. Qiang Wang
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LL: conception and design of the work, manuscript writing, manuscript revision, and checking of all data. YX: manuscript writing, manuscript revision, and checking of all data. FS: manuscript revision and checking of all data. QW: manuscript revision and checking of all data.

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Correspondence to Liang Liu.

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Liu, L., Xiao, Y., Sun, Fz. et al. Advances in Ureteral Stents in the Maintenance Therapeutic of Malignant Ureteral Stricture. Indian J Surg (2023). https://doi.org/10.1007/s12262-023-03916-8

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