The use of metallic stents to bypass ureteral strictures secondary to metastatic prostate cancer: experience with 8 patients.

Abstract

We evaluated the middle term patency, incidence of infection and ability to preserve renal function using metallic stents to bypass ureteral obstruction secondary to metastatic prostate adenocarcinoma. We studied 8 patients with ureteral obstruction secondary to metastatic prostate adenocarcinoma at the pelvic ureter with up to 48 months of followup. Metallic Wallstents* 8 mm. in diameter and 64 mm. long were placed across the stricture after preliminary dilation with a high pressure balloon. Double-J catheters were left in all patients for at least 1 month or until mucosal edema had subsided. All stents were placed via an antegrade approach. Average duration of stent patency was 19 months. All 6 patients at risk at 12 months had patent stents compared to 3 of 5 at 24 months, 2 of 2 at 36 months, and 1 of 1 at 48 months. Stent occlusion occurred in 2 patients at 8 and 12 months, respectively, and additional stents were placed telescopically to achieve recanalization. Renal function was preserved in all patients. Two patients died of disease at 1 month and 1 at 26 months after stent placement. The use of metallic stents to bypass malignant ureteral obstruction is a safe and effective method.