Introduction & Objectives
Ureteral stenosis is severe, difficult to treat and significantly affects the quality of life of patients. Usually the definitive resolution is surgical of reconstructive nature or urethral stent placement. In our experience we evaluate the use of new expandable ureteral stent (ALLIUM®) as alternative to standard ureteral stent or reconstructive surgery.
Material & Methods
From September 2013 to December 2016, 82 patients were enrolled in the study and subjected to endoscopic positioning of the urinary tract Allium®. Of the 82 patients treated, 31 had ureteral stenosis post-ureterorenoscopy, in these patients an ureteral balloon dilatation was always performed, 36 patients had stenosis as a complication of oncological disorders, 2 stenosis in patients after ureteral re-implantation, 5 stenosis in neo bladder ureteral anastomosis, 5 patients with stenosis post pieloplasty. 3 patients with urinary fistula.
Operating times were short (maximum 60 minutes), postoperative hospitalization was <48 hours in all cases except a case. There have been no cases with post-operative fever, no cases of stent migration. All patients with stenosis post-ureterorenoscopy removed the Allium® after 6 months, 23 of 31 had no hydronephrosis at 6 months follow-up, the other patients were submitted to reconstructive surgery. Patients with urinary fistula removed the Allium® stent after 6 months and in all 3 patients the fistula was resolved. Patients with neobladder ureteral anastomosis had no hydronephrosis at 6 and 12 months, in these cases the Allium® stent was not removed. In patients with stenosis post Pieloplasty, the Allium® stent was removed after 6 months, in 2 cases other surgical procedure was required because of persistent hydronephrosis. In patient with stenosis due to oncological disorders, the Allium® stent was not removed, all patients that are still living had no significant hydronephrosis and did not have disconfortor other complications. All patients with stenosis after re-implantation and stenosis in neobladder anastomosis, did not remove Allium® and have complete resolution of hydronephrosis
Allium® ureteral can be considered a device that require a short learning curve, minimal post-operative complications, less negative impact on the quality of life of patients, and is effective in treating ureteral obstructions. However, we need more cases to understand if this device can be considered as first line treatment of ureteral stenosis.