9
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      The resonance® metallic ureteral stent in the treatment of malignant ureteral obstruction: a prospective observational study

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          To study the outcomes and experiences of using metallic stents in treating patients with malignant ureteral obstruction (MUO), we examined the effects of metallic ureteral stenting using the Cook Resonance® stent in the treatment of MUO.

          Methods

          All patients who had a Resonance metallic stent inserted between April 2015 and March 2018 at one of multiple facilities were prospectively observed with a 1-year follow-up. The primary outcome was the patency rate of the metallic ureteral stent. The secondary outcomes included the complications (e.g., infection and fever).

          Results

          Although stent insertion was attempted in 50 patients, the stent could not be inserted as a ureteral stent in three patients due to severe ureteral stricture, and one ureteral cancer patient was excluded from the analysis. The remaining 46 patients’ median age was 67 years (range 28–85 years) (16 males, 30 females). Twenty-four patients died during the study; their median survival time was 226 days. The median follow-up period for the censored patients was 355 days (range 16–372 days), and just seven patients were still alive without Resonance failure > 1 year later. The women’s IPSS scores tended to be lower than those of the men. Regarding the OABSS score, although the women’s total score tended to be low, the difference between the men’s and women’s scores was nonsignificant. The bacteria detected from urine culture after stent insertion were more gram-positive than gram-negative.

          Conclusion

          Metallic ureteric stenting using the Resonance stent is safe and effective for treating MUO. Subjective symptoms were relatively less in the female patients.

          Related collections

          Most cited references36

          • Record: found
          • Abstract: found
          • Article: not found

          The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association.

          A symptom index for benign prostatic hyperplasia (BPH) was developed and validated by a multidisciplinary measurement committee of the American Urological Association (AUA). Validation studies were conducted involving a total of 210 BPH patients and 108 control subjects. The final AUA symptom index includes 7 questions covering frequency, nocturia, weak urinary stream, hesitancy, intermittence, incomplete emptying and urgency. On revalidation, the index was internally consistent (Cronbach's alpha = 0.86) and the score generated had excellent test-retest reliability (r = 0.92). Scores were highly correlated with subjects' global ratings of the magnitude of their urinary problem (r = 0.65 to 0.72) and powerfully discriminated between BPH and control subjects (receiver operating characteristic area 0.85). Finally, the index was sensitive to change, with preoperative scores decreasing from a mean of 17.6 to 7.1 by 4 weeks after prostatectomy (p < 0.001). The AUA symptom index is clinically sensible, reliable, valid and responsive. It is practical for use in practice and for inclusion in research protocols.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            The prevalence of lower urinary tract symptoms in men and women in four centres. The UrEpik study.

            To evaluate the epidemiology of lower urinary tract symptoms (LUTS) among men and women, as there are significant unanswered questions about the prevalence and impact of LUTS in different populations. A population-based, cross-sectional survey was completed in Boxmeer (the Netherlands), Auxerre (France), Birmingham (UK) and Seoul (Republic of Korea), using culturally and linguistically validated versions of the International Prostate Symptom Score (IPSS). The aim was to estimate the distribution of symptoms of LUTS in men and women. Stratified random samples of men aged 40-79 years in each community were collected. Postal questionnaires were used in Europe and direct interviews in Korea. In all, 4979 index men and 3790 women were recruited, with age-adjusted response rates among men of 72% in Boxmeer, 28% in Auxerre, 60% in Birmingham and 68% in Seoul. The percentages of men and women with an IPSS of 8-35, indicating moderate to severe symptoms, were, respectively, 20.7 and 18.0 (Boxmeer); 19.2 and 12.6 (Auxerre); 25.1 and 23.7 (Birmingham); 16.2 and 19.9 (Seoul). Among women the relationship between symptoms and age was not as strong as in men. The percentages of men and women with moderate to severe symptoms were by age group, respectively, 10.6, 15.5 (40-49); 19.0, 18.2 (50-59); 30.5, 23.8 (60-69); 40.4, 28.7 (70-79). Among those aged 40-49 the main differences between men and women were in the questions about frequency of urination during the day and holding back urine. Among the older groups men reported more symptoms on all questions apart from urination at night and difficulty in holding back urine, both of which were equally prevalent among men and women. The overall prevalence of LUTS was high and showed no marked cultural variation. Prevalence increased with age, with severe LUTS commoner in older men. Women reported similar levels of the symptoms traditionally associated with LUTS in men. In each age group there were no major cultural differences in the frequency of LUTS. There were differences with age between men and women; younger men had a lower prevalence of LUTS than younger women but older men a much higher prevalence than older women. These findings emphasize that the IPSS should be confined to within-patient comparisons and not used as a diagnostic tool. The IPSS performs very similarly regardless of gender.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              The management of malignant ureteral obstruction treated with ureteral stents.

              We developed an algorithm for the management of ureteral obstruction due to malignant extrinsic compression. We retrospectively reviewed all ureteral stents placed for noncalculous reasons at our institution from January 1, 1990 to January 1, 2004. Further clinical information was gathered from 157 patients with malignant extrinsic ureteral compression. Failure was defined as recurrent ureteral obstruction or an inability to place stents cystoscopically. A total of 157 patients underwent retrograde ureteral stent attempt for malignant extrinsic ureteral obstruction. Mean patient age was 54.7 years (range 23 to 83) and average followup was 13.6 months. Of our patients 61% were women, and the most common cancer diagnoses were ovarian cancer (in 26), lymphoma (17) and cervical cancer (16). A total of 24 patients required immediate percutaneous nephrostomy (PCN) referral. There were 32 patients who experienced a late failure and required PCN (average 180 days after initial stent), and 83 patients in our series (52.9%) who experienced 110 major complications. Type of cancer did not predict need for PCN. However, when invasion into the bladder was noted on cystoscopy, 55.9% (19 of 34, p = 0.008) progressed to PCN referral. A total of 77 patients underwent stent replacement on average 2.8 times and with an interval of 95 days. In our series patients with malignant extrinsic ureteral compression presenting for ureteral stent(s) experienced a failure rate of 35.7% (56 of 157). Invasion at cystoscopy had a significant predictive value for progression to PCN. We present an algorithm on the management of extrinsic malignant ureteral obstruction.
                Bookmark

                Author and article information

                Contributors
                jmiyazaki@iuhw.ac.jp
                mizukionozawa@gmail.com
                stakahas@sapmed.ac.jp
                yuka_mae11@yahoo.co.jp
                super7@gifu-u.ac.jp
                gmd17055@s.okadai.jp
                y-maeda@mattohp.com
                t-masaki@harasanshin.or.jp
                yamaguchi@harasanshin.or.jp
                Masahiko12o11u08@aol.com
                yasakai@cancer-c.pref.saitama.jp
                tomokazu.kim@md.tsukuba.ac.jp
                manabu11gaku@yahoo.co.jp
                k.seike-04.6.26@leaf.ocn.ne.jp
                th-uro@hyo-med.ac.jp
                shingoy@hyo-med.ac.jp
                Journal
                BMC Urol
                BMC Urol
                BMC Urology
                BioMed Central (London )
                1471-2490
                27 December 2019
                27 December 2019
                2019
                : 19
                : 137
                Affiliations
                [1 ]ISNI 0000 0004 0531 3030, GRID grid.411731.1, Department of Urology, , International University of Health and Welfare, ; 6-1-14 Kounodai, Ichikawa City, Chiba 272-0827 Japan
                [2 ]ISNI 0000 0001 0691 0855, GRID grid.263171.0, Department of Infection Control and Laboratory Medicine, , Sapporo Medical University School of Medicine, ; S1 W16, Chuo-ku, Sapporo, 060-8543 Japan
                [3 ]ISNI 0000 0004 0370 4927, GRID grid.256342.4, Department of Urology, , Gifu University Graduate School of Medicine, ; 1-1 Yanagido, Gifu City, 501-1194 Japan
                [4 ]ISNI 0000 0001 1302 4472, GRID grid.261356.5, Department of Urology, , Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, ; 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558 Japan
                [5 ]ISNI 0000 0004 0642 3012, GRID grid.459889.1, Department of Urology, , Public Central Hospital of Matto Ishikawa, ; 3-8 Kuramitsu, Hakusan-shi, Ishikawa 924-0865 Japan
                [6 ]ISNI 0000 0004 0628 9562, GRID grid.459578.2, Department of Urology, , Harasanshin Hospital, ; 1-8 Taihaku-machi, Hakata-ku, Fukuoka City, Fukuoka, 812-0033 Japan
                [7 ]GRID grid.413369.a, Department of Urology, , Kasumigaura Medical Center, ; 2-7-14 Shimotakatsu, Tsuchiura City, Ibaraki 300-0812 Japan
                [8 ]ISNI 0000 0001 2168 5385, GRID grid.272242.3, Department of Urology, , National Cancer Center East, ; 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba 277-8577 Japan
                [9 ]ISNI 0000 0001 2369 4728, GRID grid.20515.33, Department of Urology, Faculty of Medicine, , University of Tsukuba, ; Tennodai 1-1-1, Tsukuba City, Ibaraki 305-8575 Japan
                [10 ]Department of Urology, Kizawa Memorial Hospital, 590 Shimokobi, Kobicho, Minokamo, Gifu, 505-8503 Japan
                [11 ]Department of Urology, Chuno Kosei Hospital, 5-1 Wakakusadori, Seki-city, Gifu, 501-3802 Japan
                [12 ]ISNI 0000 0000 9142 153X, GRID grid.272264.7, Department of Urology, , Hyogo College of Medicine, ; 1-1 Mukogawa-cho, Nishinomiya City, Hyogo 663-8501 Japan
                Article
                569
                10.1186/s12894-019-0569-y
                6935232
                31881875
                46b6718a-a640-4984-af73-e3437bb378d7
                © The Author(s). 2019

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 18 June 2019
                : 13 December 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001691, Japan Society for the Promotion of Science;
                Award ID: 18H02934
                Award ID: 17K11124
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Urology
                metal stent,malignant ureteral obstruction,ureteral stent,metallic ureteric stenting,resonance stent

                Comments

                Comment on this article