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MINERVA UROLOGICA E NEFROLOGICA

Rivista di Nefrologia e Urologia


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Minerva Urologica e Nefrologica 2018 Mar 28

DOI: 10.23736/S0393-2249.18.03035-7

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Expandable metallic ureteral stent: indications and results. Analysis of the current literature

Gianluca SAMPOGNA, Angelica GRASSO, Emanuele MONTANARI

UOC Urologia, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy


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INTRODUCTION: Ureteral obstructions are managed by complex surgery not always feasible for surgical field complexity or poor patient conditions. Various surgical maneuvers, as ureteral dilation, stenting and percutaneous nephrostomy, can be offered, but they are related to considerable failure rates and negative impact on quality of life. In selected cases, the positioning of long-term expandable metallic ureteral stents (EMUSs) may be an appropriate and successful choice.
EVIDENCE ACQUISITION: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria, a systematic review of the literature was performed in July 2017 using PubMed, Cochrane Library, Scopus and Web of Science databases. The search was conducted by typing the following terms: “Expandable metallic ureteral stent”, “Memokath ureteral stent”, “Allium ureteral stent” and “Uventa ureteral stent”.
EVIDENCE SYNTHESIS: Twenty studies reported the safety, efficacy and clinical outcomes related to the common available EMUSs. Most studies were single-arm, retrospective and involving a low number of clinical cases, resulting in significant difficulties with outlining indications and drawing conclusions. Available papers showed EMUSs offered a high rate of patency, a long duration and a good quality of life, even if they are associated with significant complications.
CONCLUSIONS: Since the first description of ureteral stents 50 years ago, we have faced a significant evolution in stent design. The current generation of EMUSs offers many advantages, but the onset of adverse effects is still significant and limits their use to selected cases. Further research should be addressed to the realization of prospective, multi-institutional randomized clinical trials to highlight indications to manage appropriately ureteral obstructions.


KEY WORDS: Ureteral obstruction - Ureteral diseases - Stents - Self expandable metallic stents

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Publication History

Article first published online: March 28, 2018
Manuscript accepted: March 12, 2018
Manuscript revised: January 8, 2018
Manuscript received: August 14, 2017

Per citare questo articolo

Sampogna G, Grasso A, Montanari E. Expandable metallic ureteral stent: indications and results. Analysis of the current literature. Minerva Urol Nefrol 2018 Mar 28. DOI: 10.23736/S0393-2249.18.03035-7

Corresponding author e-mail

emanuele.montanari@unimi.it