Treatment of ureteral obstructions with the Wallstent endoprosthesis: preliminary results.

ABSTRACT

PURPOSE: To evaluate the efficacy of the Wallstent endoprosthesis in the treatment of ureteral strictures. PATIENTS AND METHODS: Wallstents with diameters of 10 mm were placed across five malignant and six benign ureteral strictures in eight patients. All patients were believed to have poor surgical options, and their strictures were being maintained with catheter drainage. Ten lesions involved ureteroenteric anastomoses, and one malignancy involved the midureter. RESULTS: Three stents (two patients) across malignant disease remained patent until the time of patient death (3-5 months); the remaining two stents (one patient) became occluded within 1 month. Only one of six stents placed for benign disease remained patent at 11 months. All occlusions in benign strictures resulted from ingrowth of hyperplastic urothelium and granulation tissue. Complete obstruction was usually present only focally within the stent. The malignant occlusions were caused by tumor ingrowth and granulation tissue. No major complications were directly related to the stents, but two infections occurred. CONCLUSION: Wallstent endoprostheses are ineffective in providing long-term relief in patients with benign ureteroenteric strictures. Further evaluation of their role in malignant strictures is needed.