Malignant ureteral obstruction: Treatment with metal stents - Technique, results, and observations with percutaneous intraluminal US

PURPOSE: To test the technical feasibility and results of placement of metal stents into ureters obstructed by extensive tumor. MATERIALS AND METHODS: Six consecutive patients (two men and four women, aged 35-66 years and with incurable malignancies) underwent insertion of metallic endoprostheses in nine obstructed ureters through percutaneous tracts. RESULTS: Metal stents were inserted without technical difficulty in all obstructed ureters. The stents functioned well in four patients. In two patients, the metal stents were not tolerated and plastic double-J stents were placed through the metal stents; this permitted effective functioning and withdrawal of the protective external catheter. Intraluminal ultrasonography depicted stent clogging and debris, dimensions of stent opening, and tumor level. CONCLUSION: Insertion of metal stents in the ureter is technically straightforward and was well tolerated by patients. However, the efficacy is variable, and a greater beneficial effect than is achieved with plastic stents is not established.