The Wallstent: Long-term follow-up of metal stent placement for the treatment of benign ureteroenteric anastomotic strictures after Bricker urinary diversion - Abstract

OBJECTIVE: To (1) evaluate the long-term follow-up (primary and secondary patency) of metal stent placement in benign uretero-ileal anastomotic strictures following Bricker urinary diversion and (2) to compare the failed treatment group with the group of successfully treated patients to search for predisposing factors of stent failure.

PATIENT AND METHODS: Of all patients treated since 1989, for benign uretero-ileal strictures after Bricker urinary diversion with end-to-side anastomosis, we retrospectively collected data on clinical history, stent placement, auxiliary measures and patency rates from a prospectively kept database.

RESULTS: Forty-nine patients (mean age: 64 years) underwent 56 metal stent procedures. Placement of the stent was possible in all patients. Stent patency without auxiliary treatment remained adequate in 23 cases (primary patency of 41.1%, mean follow-up 37.7 months). A secondary treatment was successfully performed in 11 patients who suffered from stent obstruction, mostly caused by hyperplastic reaction, encrustation, or migration of the stent. Secondary patency rate was 60.7% (mean follow-up 55.8 months), comparable with patency rates of 36 to 100% described in literature with mostly small patient groups and much shorter follow-up period.

CONCLUSION: To the best of our knowledge we report the largest series of metal stenting in benign uretero-ileal anastomotic strictures with the longest follow-up. We show that placement of a metal stent can lead to a permanent desobstruction in approximately 6 out of 10 patients with preservation of renal function.

Written by:
Campschroer T, Lock MT, Lo TH, Bosch JL.   Are you the author?
Department of Urology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.

Reference: BJU Int. 2014 Mar 6. Epub ahead of print.
doi: 10.1111/bju.12729

PubMed Abstract
PMID: 24602310 Endourology Section