Initial experience of a novel ureteral silicon-covered metallic mesh stent in malignant ureteric obstruction

Abstract

Abstract Purpose To investigate initial experiences and outcomes of a retrograde inserted new silicone-covered metallic ureteric stent (Urexel™) for malignant ureteric obstruction. Methods We reviewed the medical records for 12 consecutive patients who underwent Urexel™ stent placement for malignant ureteric obstruction from March 2020 to March 2021. The Urexel™ stent is a segmental metallic ureteric stent composed of a nitinol mesh covered with a silicone membrane. We evaluated the clinical outcomes and complications of this new metallic ureteric stent. Results The median age of patients was 61.5 (44–82) years, and the median follow-up was 25.5 (4–37) months. One of the 12 patients underwent bilateral stent insertion, Urexel™ stents were placed in a total of 13 ureteral units. There was no technical failure during stent placement. The median length of obstructions was 9 (1–22) cm. Balloon dilation was necessary in 38.5% (5/13 ureter units) of cases. The 1-year success rate was 76.9%, 2-year success rate was 61.5, and overall success rate was 53.8%. Encrustation, migration and hyperplasia were the cause of overall treatment failure in all 6 cases of failure, with median elapsed time to failure of 9.5 (1–30) months. Common complications included persistent pain, acute pyelonephritis, and lower urinary tract symptoms, but they were Clavien-Dindo grade I or II. Conclusions In this initial series of novel ureteral silicon-covered metallic mesh stents, Urexel™ showed favorable outcomes with a high success rate and acceptable complication rate in malignant ureteric obstructions.