Location

Suwanee, GA

Start Date

11-5-2023 1:00 PM

End Date

11-5-2023 4:00 PM

Description

Introduction and Objective

Chronic ureter stenting is recommended for patients with malignant ureteral obstruction, or with benign ureteral obstruction that cannot tolerate or do not want definitive surgical management. Stents are exchanged at time intervals often limited by stent encrustation. Prior in vitro studies have demonstrated that silicone stents have less encrustation. Our objective was to compare patients undergoing chronic exchanges with polymer-based and silicone stents.

Methods

This IRB-approved retrospective study included all adult patients who underwent chronic ureter stent exchange from August 2017 through August 2022. Patients were stented with either a Boston Scientific PercuflexTM Plus or a Cook Black Silicone stent. Demographics, dates of exchange, stent type and size, and the presence of external and luminal encrustation were captured from operative reports. A subset of patients with > 8F stents was analyzed given larger stents have lower rates of encrustation. Students t-test and chi-squared analysis were used to compare polymer-based vs silicone stents.

Results

In total, 52 patients underwent 165 stent exchanges: 72% were polymer-based (n=119), 28% were silicone (n=44), and 1% were metallic (n=2, excluded). Table 1 lists patient demographics and stent sizes. Mean exchange interval for silicone stents was significantly longer than for polymer-based stents (197 ± 60 vs 139 ± 87 days, p<0.0001). Despite this, there was no significant difference in external encrustation (9 vs 18%, p=0.18) or luminal encrustation (7% vs 4%, p=0.49). Sub-group comparison of stents > 8F also showed longer exchange interval (191 ± 40 vs 106 ± 36 days, p<0.0001), similar external encrustation (10.3 vs 24%, p=0.13), and similar luminal encrustation (6.9 vs 5.6%, p=0.82).

Discussion

Utilizing silicone stents for chronic ureter stent exchanges significantly increases the exchange interval due to lower encrustation rates over similar time periods compared to a polymer-based stent. Further work with other polymer-based and silicone stents is warranted to evaluate the generalizability of these results.

Source of funding: none

COI: Consultant for Boston Scientific and Cook Medical, this study is unfunded.

Embargo Period

6-22-2023

Included in

Urology Commons

COinS
 
May 11th, 1:00 PM May 11th, 4:00 PM

Silicone stenting for chronic ureteral obstruction improves stent exchange frequency

Suwanee, GA

Introduction and Objective

Chronic ureter stenting is recommended for patients with malignant ureteral obstruction, or with benign ureteral obstruction that cannot tolerate or do not want definitive surgical management. Stents are exchanged at time intervals often limited by stent encrustation. Prior in vitro studies have demonstrated that silicone stents have less encrustation. Our objective was to compare patients undergoing chronic exchanges with polymer-based and silicone stents.

Methods

This IRB-approved retrospective study included all adult patients who underwent chronic ureter stent exchange from August 2017 through August 2022. Patients were stented with either a Boston Scientific PercuflexTM Plus or a Cook Black Silicone stent. Demographics, dates of exchange, stent type and size, and the presence of external and luminal encrustation were captured from operative reports. A subset of patients with > 8F stents was analyzed given larger stents have lower rates of encrustation. Students t-test and chi-squared analysis were used to compare polymer-based vs silicone stents.

Results

In total, 52 patients underwent 165 stent exchanges: 72% were polymer-based (n=119), 28% were silicone (n=44), and 1% were metallic (n=2, excluded). Table 1 lists patient demographics and stent sizes. Mean exchange interval for silicone stents was significantly longer than for polymer-based stents (197 ± 60 vs 139 ± 87 days, p<0.0001). Despite this, there was no significant difference in external encrustation (9 vs 18%, p=0.18) or luminal encrustation (7% vs 4%, p=0.49). Sub-group comparison of stents > 8F also showed longer exchange interval (191 ± 40 vs 106 ± 36 days, p<0.0001), similar external encrustation (10.3 vs 24%, p=0.13), and similar luminal encrustation (6.9 vs 5.6%, p=0.82).

Discussion

Utilizing silicone stents for chronic ureter stent exchanges significantly increases the exchange interval due to lower encrustation rates over similar time periods compared to a polymer-based stent. Further work with other polymer-based and silicone stents is warranted to evaluate the generalizability of these results.

Source of funding: none

COI: Consultant for Boston Scientific and Cook Medical, this study is unfunded.