Reconsidering metal stenting of the upper urinary tract at the pre-conference symposium at the 2nd EULIS Meeting

Thu, 11 Apr 2013

The new generation of metal stents has several advantages over plastic stents, and urologists need to be aware of the long-term benefits. The EAU Section of Urolithiasis (EULIS) is holding its second annual meeting in Copenhagen on 5-7 September. The meeting will be preceded on September 4th by the 1st International Symposium on Metal Stenting of the Upper Urinary Tract.

This symposium is chaired by Mr. Noor Buchholz (GB) and Dr. Mette Holm (DK). “EULIS deals with all aspects of stone disease, as well as stone surgery. Stenting is an integrated part of stone work, and the stent is part of our armamentarium,” Mr. Buchholz explained. “This is –to my knowledge- the first time that a symposium deals exclusively with metal stents. This is a new technology, which is about ten years old, and we can finally present the long-term benefits of the use of metal stents.”

There is generally considered to be a lack of awareness of metal stenting among urologists, and where there is awareness, there is reluctance. “The reason for this is poor experiences with the older generation of metal stents, the so-called mesh stents. These would in time get overgrown with urothelium, and would be very difficult to remove.”

“This new generation is a totally different in technology and properties. They can be applied with minimally invasive surgery, and are easy to place and remove.”

Proven advantages of metal stents

After ten years of experience with several hundred passengers, Mr. Buchholz and other presenters will be bringing their know-how to the audience. “We now have a series of 200 patients in one study, on which we have published extensively, as well as several hundred other cases treated and on long-term surveillance, five years after treatment.”

The metal stent comes into play whenever long-term stenting is required. Using plastic stenting means they typically have to be replaced every 3-12 months. Buchholz: “That means patients need to be operated on twice a year on average. Metal stents can stay in the body for much longer periods of time. One of our patients has now had a stent for eight years, and the literature shows examples of ten years of continuous use.”

Urologists may have also been hesitant to consider metal stents due to the high purchase price. “It can be difficult to make a case for spending more than ten times the cost of a plastic double-J stent. However, once you take into account the costs of repeated surgical procedures, metal stents like the Memokath become cost-effective after one year, despite their much higher purchase price.”

The Symposium

The Symposium takes place the day before the 2nd EULIS Meeting, and brings together international speakers, each an authority on the use of a different kind of metal stent. The symposium will feature live surgery from the Rigshospitalet in Copenhagen, Denmark’s biggest hospital. Buchholz: “The live surgery will demonstrate the insertion of the stents. We want to raise awareness in the urological community of the developments with metal stents, and emerging evidence of favourable results.”

The day-long programme concludes with a workshop dinner, giving delegates a chance to speak informally with the faculty and speakers.

The 1st International EULIS pre-conference symposium on metal stenting of the ureter will take place prior to the 2nd Meeting of the EAU Section of Urolithiasis. Please visit the meeting website to find out more about the symposium and the meeting and to register.