Initial experience of a novel ureteral silicon-covered metallic mesh stent in malignant ureteric obstruction: a single-center retrospective study

BMC Urol. 2024 Dec 19;24(1):268. doi: 10.1186/s12894-024-01653-y.

Abstract

Background: This study aimed to investigate initial experiences and outcomes of a retrograde inserted new silicone-covered metallic ureteric stent (Urexel™) for malignant ureteric obstruction.

Methods: We retrospectively reviewed the medical records for 12 consecutive patients who underwent Urexel™ stent placement for malignant ureteric obstruction from March 2020 to March 2021. The Urexel™ stent is a segmental metallic ureteric stent composed of a nitinol mesh covered with a silicone membrane. We evaluated the clinical outcomes and complications of this new metallic ureteric stent.

Results: The median age of patients was 61.5 (44-82) years, and the median follow-up was 25.5 (4-37) months. One of the 12 patients underwent bilateral stent insertion, Urexel™ stents were placed in a total of 13 ureteral units. There was no technical failure during stent placement. The median length of obstructions was 9 (1-22) cm. Balloon dilation was necessary in 38.5% (5/13 ureter units) of cases. The 6-month success rate was 83.3%, 1-year success rate was 70%, and estimated success rate was 44.4% at 2-year. Encrustation, migration and hyperplasia were the cause of overall treatment failure in all 6 cases of failure, with median elapsed time to failure of 9.5 (1-30) months. Common complications included persistent pain, acute pyelonephritis, and lower urinary tract symptoms, but they were Clavien-Dindo grade I or II.

Conclusions: In this initial series of novel ureteral silicon-covered metallic mesh stents, Urexel™ provided acceptable success and complication rate in malignant ureteric obstructions.

Keywords: Clinical outcome; Malignant ureteric obstruction; Metallic ureteric stent; Retrograde manner; Ureteral stent.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prosthesis Design*
  • Retrospective Studies
  • Silicon
  • Silicones
  • Stents* / adverse effects
  • Treatment Outcome
  • Ureter / surgery
  • Ureteral Neoplasms / complications
  • Ureteral Neoplasms / surgery
  • Ureteral Obstruction* / etiology
  • Ureteral Obstruction* / surgery

Substances

  • Silicon
  • Silicones