Moderated Poster Session
MP21-5 - The safety and efficacy of Cook Resonance® metallic ureteric stent in the treatment of chronic obstruction: The North Wales experience
Saturday, September 22
2:00 PM - 4:00 PM
Location: Room 243
Obinna Obi-Njoku, MD
Speciality Registrar Urology, Wrexham Maelor Hospital NHS Wales
Membership of The Royal College of Surgeons England(MRCSeng)
Speciality Nurse, Wrexham Maelor Hospital NHS Wales
Research lead, North Wales & North West Urological Research Centre Wrexham Maelor Hospital, BCUHB, Wrexham, North Wales, UK
Introduction & Objective :
We evaluated the efficacy and safety of metallic ureteric stenting using the Cook Resonance® stent in the treatment of chronic ureteric obstruction, with medium-term follow up.
All patients who had a Resonance® metallic stent inserted between April 2009 and April 2018 in our institution were identified from a prospectively maintained stent-database. Primary outcome was relief of ureteric obstruction, defined by successful clinical and radiological treatment of hydronephrosis/hydroureter. Secondary outcome measures included operative time, radiological exposure, total stent dwell time (defined as the cumulative time in months for which a Resonance® metallic stent was in situ), early and late complications.
Forty patients underwent 114 stent insertion episodes (SIE). Median age was 68 years (range 33–90). Stent insertion resulted in successful treatment of hydronephrosis/hydroureter in 91.2% (10 SIE resulted in failure to relieve ureteric obstruction). Median operative time per procedure (bilateral or unilateral) was 30 min (range 20–60) and median radiation exposure was 537.15 cGy/cm2 (range 16.55–5366). Median stent dwell time was 24 months (range 2–76) in non-malignant and 13 months (range 2–80) in malignant ureteric obstruction. One stent migrated proximally during insertion and had to be retrieved using an antegrade approach. Four patients were readmitted with post-operative urinary tract infection. Among the 4 patients, 2 developed urosepsis but recovered on treatment with IV antibiotics without need for HDU/ITU. In addition, 5 patients were re-admitted with haematuria which resolved without intervention or blood transfusion. However, four of them were later seen in clinic complaining of persistent haematuria and lower urinary tract symptoms(LUTS).
Metallic ureteric stenting using the Resonance® stent is safe and effective for treating ureteric obstruction from both malignant and benign causes. The success rate in our series was 91.2% and complications were minimal.