Learning from Our Mistakes: Applying Vascular Stent Technologies to the Urinary Tract

Abstract

AbstractThe aim of this chapter is to clarify certain points which are confusing many if not most of our urologist colleagues on the subject of “stents and stenting the urinary tract”. Another point of confusion in urology is the term of “chronic obstruction” describing an obstruction necessitating long-term stenting. Which stent to use? For how long? Before using a permanent stent along the urinary tract we should think hard about what may happen to a ureter or urethra implanted with a permanent metallic mesh stent. This is especially important when something goes wrong like when the stent lumen becomes obliterated by hyperplastic or malignant tissues, the stent wires fracture, or tissue coverage over the stent wires is incomplete and the resulting stone formation on the wires, ureteral or urethral perforations etc. By adopting the vascular stent technologies in urinary tract design stents, we were hoping that taking a single stent shape, changing its length and caliber they could be used all along the urinary tract. Then asking ourselves, why the results were less than what we were expecting. Here I would like to quote a sentence attributed to Albert Einstein: “Insanity is doing the same thing over and over again and expecting different results”.