Login to Access Video or Poster Abstract: MP75-08
Sources of Funding: None

Introduction

Metallic stents have been shown to be advantageous for chronic ureteral obstruction. Non-metallic stents have historically been used for short term applications due to their propensity to encrust and obstruct. We present our 8-year experience with a novel non-metallic stent with a 365-day dwell time.

Methods

Since 2008 we placed Bard Optima (Covington, GA) stents for ureteral obstruction in patients not deemed suitable for definitive surgical management. Goal was to exchange stents annually. Indications included – malignant obstruction (11), calculus stricture (10), retroperitoneal fibrosis (5), radiation injury (3), ileal-ureter anastomotic stricture (2) and ureteral pelvic junction (2). Patients underwent initial cystoscopy and placement of 7F stent with subsequent upsizing to 8F. Initially stents were exchanged every 6-9 months, but with experience we exchanged them annually, unless the patient became symptomatic. Patency was evaluated by passage of wire through the stent lumen.

Results

From 2008 to 2016, twenty-four patients and 32 renal units were managed by long-term stent placement. Total of 112 stents were exchanged in this time. Shortest and longest dwell times were 70 days and 742 days, respectively. Exterior stent encrustations were noted in 23% of exchanges. Nonetheless, stents remained patent in 93% of exchanges, with mean dwell time of 280 days.

Conclusions

To our knowledge this is the first long term series evaluating non-metallic ureteral stents for long-term placement for various causes of ureteral obstruction. The Bard Optima stent is a good alternative to long-term metallic stents. Compared the metallic stents, Optima stents are placed easily over a wire to facilitate ease of use and adoption. Additionally, cost is substantially lower and patient comfort has been exceptional._x000D_

Funding

None