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Outcomes following Exchange and Upsizing of Malfunctioning Small-Caliber Double-J Ureteral Stents.

Authors :
Hung, Matthew L.
Nadolski, Gregory J.
Mondschein, Jeffrey
Cobb, Ryan
Trerotola, Scott O.
Source :
Journal of Vascular & Interventional Radiology; Nov2023, Vol. 34 Issue 11, p1908-1913, 6p
Publication Year :
2023

Abstract

To determine the effectiveness of exchange and upsizing of malfunctioning small-caliber double-J (JJ) ureteral stents. Thirty-one patients with malfunctioning cystoscopically placed small-caliber (6 or 7 F) JJ stents underwent transurethral (n = 28) or transrenal (n = 3) exchange and upsizing to a large-caliber (10 F) JJ stent from 2013 to 2022. Ureteral obstruction was malignant in 20 patients (65%) and benign in 11 (35%). Fifteen patients (48%) presented with persistent hydroureteronephrosis and 16 patients (52%) with worsening hydronephrosis. Acute kidney injury (AKI) was present in 19 patients (61%) at the time of stent malfunction. Therapeutic success was defined as resolution of hydronephrosis and AKI, if present. JJ stent exchange and upsizing was technically successful in 31 patients (100%) with no immediate adverse events. Therapeutic success was achieved in 27 patients (87%). During follow-up (median, 97 days; IQR, 32–205 days), 2 patients who initially achieved therapeutic success had stent malfunction, requiring conversion to percutaneous nephrostomy drainage (2/27, 7%). Exchange and upsizing to large-caliber JJ stents can relieve urinary obstruction and resolve AKI in patients with malfunctioning small-caliber JJ stents. Large-caliber JJ stents should be considered as a salvage option for patients who wish to continue internal drainage and avoid percutaneous nephrostomy. [Display omitted] [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
10510443
Volume :
34
Issue :
11
Database :
Supplemental Index
Journal :
Journal of Vascular & Interventional Radiology
Publication Type :
Academic Journal
Accession number :
173013436
Full Text :
https://doi.org/10.1016/j.jvir.2023.07.013