Nephrovesical subcutaneous stent: an alternative to permanent nephrostomy.

Abstract

PURPOSE: We studied whether a subcutaneous ureteral bypass may be an alternative to a permanent nephrostomy tube in patients with ureteral obstruction caused by pelvic malignancy. MATERIALS AND METHODS: Using local anesthesia we inserted an especially designed nephrovesical stent into subcutaneous tissue. The stent consists of 2 J stents that are joined by a connector after insertion into the renal pelvis and bladder. RESULTS: In 8 patients 10 subcutaneous stents were inserted instead of a permanent nephrostomy tube. Nephrostomy was required because of obstructed ureters caused by metastatic prostate or invasive bladder cancer. Attempted Double-J stent insertion into the obstructed ureter had previously failed. The bypass has functioned well in all cases during 6 weeks to 18 months of followup (mean 5.5 months). CONCLUSIONS: The high complication rate of a permanent nephrostomy tube and frequent rehospitalization render the subcutaneous stent an important alternative to nephrostomy. The subcutaneous stent eliminates external devices for urine drainage and improves patient quality of life.