Experience with domestic local nitinol stents in patients with benign ureteral obstruction

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Дәйексөз келтіру

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Рұқсат жабық Рұқсат ақылы немесе тек жазылушылар үшін

Аннотация

Objective. To evaluate the efficacy and safety of intraluminal nitinol ureteral stents (“MIT”, Russia) in patients with benign ureteral strictures who experience a significant decline in their quality of life due to standard drainage systems and have contraindications to radical surgical treatment.

Materials and Methods. Between 2021 and 2025, a total of 27 MIT nitinol stents were implanted in 25 patients with benign ureteral obstruction. In the first stage, all the patients underwent an endoscopic assessment of the stricture determining its length, followed by a temporary placement of a double J stent. In the second stage, an intraluminal stent was implanted. The effectiveness was evaluated based on technical and clinical success, as well as changes in quality of life assessed by the Visual Analogue Scale (VAS).

Results. The mean operative time was 35 [30; 41] minutes. Technical success was achieved in 92% of the patients. A significant improvement in quality of life was observed in most patients, with the median VAS score increasing from 21 [20; 26] to 86 [77; 90] points 3 months after the implantation. Mild stent-related symptoms persisted in 6 patients. Additional interventions were required in 6 patients (8 interventions). In 4 cases, stent encrustations had to be removed endoscopically; in 2 cases, endoscopic correction of stent position was performed; in 2 cases, additional drainage was required due to mucosal hyperplasia at the contact points of the stent ends.

Discussion. Intraluminal nitinol stents demonstrate high clinical efficacy and may serve as a viable alternative to standard drainage systems in patients who are not candidates for reconstructive surgery. Their use is associated with fewer side effects and a significant improvement in quality of life. However, stent implantation carries a risk of complications such as encrustation, migration, and mucosal hyperplasia. Therefore, careful patient selection, adherence to technical standards of implantation, and regular follow-up are essential.

Conclusion. The introduction of MIT nitinol ureteral stents into clinical practice shows promising results in patients with benign ureteral strictures. Further studies involving larger patient cohorts and longer follow-up periods are needed to refine indications and optimize patient management strategies.

Толық мәтін

Рұқсат жабық

Авторлар туралы

Stanislav Serikov

Burnazyan Federal Medical Biophysical Centre – Medical and Biological University of Innovation and Further Education; Civil Aviation Central Clinical Hospital

Email: stanislavserikov1@gmail.com
ORCID iD: 0000-0002-3180-7291

Postgraduate Student, Department of Urology and Andrology

Ресей, Moscow; Moscow

Aleksey Martov

Burnazyan Federal Medical Biophysical Centre – Medical and Biological University of Innovation and Further Education; Lomonosov Moscow State University (Lomonosov University); Civil Aviation Central Clinical Hospital; Medical Institute of Continuing Education «ROSBIOTECH»

Хат алмасуға жауапты Автор.
Email: martovalex@mail.ru
ORCID iD: 0000-0001-6324-6110

Corresp. Member of the RAS, Doctor of Medical Sciences, Professor, Head of the Urological Center, Head of the Department of Urology and Andrology, Leading Researcher of the Medical Scientific and Educational Center, Professor of the Department of Urology

Ресей, Moscow; Moscow; Moscow; Moscow

Akhmedkhan Pshikhachev

Civil Aviation Central Clinical Hospital; Maykop State Technological University

Email: pshich@yandex.ru
ORCID iD: 0000-0002-4424-3261

Doctor of Medical Sciences, Deputy Chief Physician for Medical Affairs, Acting Head and Professor of the Department of General Surgery

Ресей, Moscow; Maykop

Sergey Dutov

Burnazyan Federal Medical Biophysical Centre – Medical and Biological University of Innovation and Further Education; Civil Aviation Central Clinical Hospital

Email: hammerwise@gmail.com
ORCID iD: 0000-0002-5384-355X

Candidate of Medical Sciences, Urologist, Department of Urology, Assoc.Prof.(Docent), Department of Urology and Andrology

Ресей, Moscow; Moscow

Andrey Andronov

Burnazyan Federal Medical Biophysical Centre – Medical and Biological University of Innovation and Further Education; Civil Aviation Central Clinical Hospital

Email: dr.andronov@mail.ru
ORCID iD: 0000-0002-5492-6808

Candidate of Medical Sciences, Head of the Department of Urology, Assoc.Prof.(Docent), Department of Urology and Andrology,

Ресей, Москва; Москва

Әдебиет тізімі

  1. Sunaryo PL, May PC, Holt SK, Sorensen MD, Sweet RM, Harper JD. Ureteral Strictures Following Ureteroscopy for Kidney Stone Disease: A Population-based Assessment. Journal of Urology. 2022;208(6):1268–75.
  2. Hammad FT. The long-term renal effects of short periods of unilateral ureteral obstruction. Int J Physiol Pathophysiol Pharmacol. 2022;14(2):60.
  3. Su B, Hu W, Xiao B, Liu Y, Zhang G, Tang Y et al. Long-term outcomes of Allium ureteral stent as a treatment for ureteral obstruction. Sci Rep. 2024;14(1).
  4. Lucas JW, Ghiraldi E, Ellis J, Friedlander JI. Endoscopic Management of Ureteral Strictures: an Update. Curr Urol Rep. 2018;19(4).
  5. Kapogiannis F, Spartalis E, Fasoulakis K, Tsourouflis G, Dimitroulis D, Nikiteas NI. Laparoscopic and Robotic Management of Ureteral Stricture in Adults. In Vivo (Brooklyn). 2020;34(3):965.
  6. Yang K, Pang KH, Fan S, Li X, Osman NI, Chapple CR et al. Robotic ureteral reconstruction for benign ureteral strictures: a systematic review of surgical techniques, complications and outcomes: Robotic Ureteral Reconstruction for Ureteral Strictures. BMC Urol. 2023;23(1).
  7. Martov AG, Popov S V, Obidnyak VM, Gadjiev NK, Guseynov RG, Gorelov DS, et al. [Design and materials for ureteral stents: past, present and future]. Urologiia. 2020;(2):85–92.
  8. Cardoso A, Coutinho A, Neto G, Anacleto S, Tinoco CL, Morais N et al. Percutaneous nephrostomy versus ureteral stent in hydronephrosis secondary to obstructive urolithiasis: A systematic review and meta-analysis. Asian J Urol. 2023;11(2):261.
  9. Scarneciu I, Lupu S, Pricop C, Scarneciu C. Morbidity and impact on quality of life in patients with indwelling ureteral stents: A 10-year clinical experience. Pak J Med Sci. 2015;31(3):522–26.
  10. Putrantyo II, Warli SM, Siregar GP, Prapiska FF, Kadar DD, Sihombing B. Role of ureteral stent material and coating to prevent ureteral stent related issue: A systematic review and meta analysis. Archivio Italiano di Urologia e Andrologia. 2024;96(1).
  11. Zul Khairul Azwadi I, Norhayati MN, Abdullah MS. Percutaneous nephrostomy versus retrograde ureteral stenting for acute upper obstructive uropathy: a systematic review and meta-analysis. Sci Rep. 2021;11(1).
  12. Miyaoka R, Monga M. Ureteral stent discomfort: Etiology and management. Indian J Urol [Internet]. 2009 Oct 1 [cited 2025 Jun 14];25(4):455. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2808646/
  13. Al-Marhoon MS, Shareef O, Venkiteswaran KP. Complications and outcomes of JJ stenting of the ureter in urological practice: A single-centre experience. Arab J Urol. 2012;10(4):372–7.
  14. Choi J, Chung KJ, Choo SH, Han DH. Long-term outcomes of two types of metal stent for chronic benign ureteral strictures. BMC Urol. 2019;19(1).
  15. Kim M, Hong B, Park HK. Long-term outcomes of double-layered polytetrafluoroethylene membrane-covered self-expandable segmental metallic stents (Uventa) in patients with chronic ureteral obstructions: Is it really safe? J Endourol. 2016;30(12):1339–46.
  16. Bahouth Z, Moskovitz B, Halachmi S, Nativ O. Allium Stents: A Novel Solution for the Management of Upper and Lower Urinary Tract Strictures. Rambam Maimonides Med J. 2017;8(4):e0043.
  17. Forster LR, Watson L, Breeze CE, Di Benedetto A, Graham S, Patki P et al. The Fate of Ureteral Memokath Stent(s) in a High-Volume Referral Center: An Independent Long-Term Outcomes Review. J Endourol. 2021;35(2):180–6.
  18. Su B, Hu W, Xiao B, Liu Y, Zhang G, Tang Y et al. Long-term outcomes of Allium ureteral stent as a treatment for ureteral obstruction. Sci Rep. 2024;14(1).
  19. Chung KJ, Park BH, Park B, Lee JH, Kim WJ, Baek M et al. Efficacy and safety of a novel, double-layered, coated, self-expandable metallic mesh stent (UventaTM) in malignant ureteral obstructions. J Endourol. 2013;27(7):930–35.
  20. Tomer N, Garden E, Small A, Palese M. Ureteral Stent Encrustation: Epidemiology, Pathophysiology, Management and Current Technology. Journal of Urology. 2021;205(1):68–77.
  21. Choi J, Chung KJ, Choo SH, Han DH. Long-term outcomes of two types of metal stent for chronic benign ureteral strictures. BMC Urol. 2019;19(1).
  22. Avitan O, Bahouth Z, Shprits S, Gorenberg M, Halachmi S. Allium Ureteral Stent as a Treatment for Ureteral Stricture: Results and Concerns. Urol Int. 2022;106(5):482.

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Әрекет
1. JATS XML
Жүктеу
2. Fig. 1. Mesh local stent-endoprosthesis with an internal polyurethane coating, MIT LLC (Russia). Stent exiting the tubular delivery system

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3. Fig. 2. Stages of local stent-endoprosthesis placement. A — Determining stent boundaries under visual control: 1 — ursteropyeloscope, 2 — stricture boundaries (medical needles), 3 — guidewire. B — Advancing the delivery system into the ureter: 4 — radiopaque markers of the ureteral stent; C — Deployment of the stent-endoprosthesis (see Figure 1); D — Administration of contrast agent to determine stent patency.

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4. Fig. 3. A — Narrowing of the local stent but a "waist" in the stricture area (indicated by the arrow) at the time of placement. B — After 3 months (the "waist" has disappeared).

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Метадеректер
5. Fig. 4. Placement of a local stent for a stricture localized in the lower third of the ureter. A — Narrowing of the stent lumen at the ureteral orifice (indicated by the arrow), native radiograph. B — Radiograph after retrograde administration of contrast agent

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6. Fig. 5. Stent implantation 15 months after placement

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