Single-Centre Experience with Three Metallic Ureteric Stents (Allium® URS, Memokath™-051 and Resonance®) for Chronic Ureteric Obstruction.

Patients with chronic ureteric obstruction (CUO) are traditionally managed with polymer stents/nephrostomy. However, these are prone to failure and require regular exchange. This study evaluates efficacy of Allium® URS, Memokath™-051 and Resonance® metallic ureteric stents in managing patients with CUO.

Following institutional approval, operating theatre records were reviewed to identify patients with CUO managed with either Allium® URS, Memokath™-051 or Resonance® metallic ureteric stents (September 2015/July 2020). Baseline patient variables (age, gender, underlying aetiology, ASA) and stricture characteristics (length, level, continuity) were extracted. Intra- and post-operative clinical and radiological assessments at 6 weeks, 3 months and then every 6 months, as well as any emergency attendances, were reviewed. The primary outcome was duration of functional stent survival. Secondary outcomes included intra-operative placement success and, as anestimate of renal function, mean serum creatinine over time.

129 stent insertion episodes (SIEs) (Allium® URS: 23, Memokath™-051: 48, Resonance®: 58) occurred in 76 patients (Allium® URS: 16; Memokath™-051: 31; Resonance®: 29). Kaplan-Meier estimates demonstrated that Resonance® provided superior functional stent survival. Overall median actual functional stent follow-up was 11.4 months for Allium® URS, 5.5 months for Memokath™-051 and 11.7 months for Resonance®. 47.8% of Allium® URS (11/23), 64.6% of Memokath™-051 (31/48) and 19% of Resonance® SIEs (11/58) failed. No Resonance® SIEs for benign indication ended in failure. Intra-operative placement success was high (Allium® URS: 95.7%; Memokath™-051 and Resonance®: both 100%). In the first year following SIE, creatinine ranged from +21.3% to +46.7% for Allium® URS, -7.8% to +8.9% for Memokath™-051, and -9.4% to +27.3% for Resonance®.

Allium® URS, Memokath™-051 and Resonance® metallic ureteric stents are all viable management options of CUO. In this cohort, Resonance® provided superior functional stent survival. Prospective large-scale comparisons with long-term follow-up are needed to help inform stent choice dependant on individual patient and stricture characteristics.

Journal of endourology. 2021 Jun 02 [Epub ahead of print]

Christopher Charles Khoo, Carmen Ho, Varun Palaniappan, Andrew Ting, Luke Forster, Mitra Kondjin-Smith, Hamid Abboudi, Milad Hanna, Tamer El-Husseiny, Ranan Dasgupta

Imperial College Healthcare NHS Trust, 8946, Imperial Endourology, London, United Kingdom of Great Britain and Northern Ireland; ., Imperial College Healthcare NHS Trust, 8946, Imperial Endourology, London, United Kingdom of Great Britain and Northern Ireland; ., Imperial College Healthcare NHS Trust, 8946, Imperial Endourology, London, United Kingdom of Great Britain and Northern Ireland; ., Imperial College Healthcare NHS Trust, 8946, Imperial Endourology, London, United Kingdom of Great Britain and Northern Ireland; ., Imperial College Healthcare NHS Trust, 8946, Imperial Endourology, London, United Kingdom of Great Britain and Northern Ireland; ., Imperial College Healthcare NHS Trust, 8946, Imperial Endourology, London, United Kingdom of Great Britain and Northern Ireland; ., Imperial College Healthcare NHS Trust, 8946, Imperial Endourology, London, United Kingdom of Great Britain and Northern Ireland; ., Imperial College Healthcare NHS Trust, 8946, Imperial Endourology, London, United Kingdom of Great Britain and Northern Ireland; ., Imperial College Healthcare NHS Trust, 8946, Imperial Endourology, London, United Kingdom of Great Britain and Northern Ireland; ., Imperial College Healthcare NHS Trust, 8946, Imperial Endourology, London, United Kingdom of Great Britain and Northern Ireland; .

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