A New Technique for the Treatment of Ureteral Stricture in Patients with Solitary Kidney
Yixiong Zhan, Jiaxin Yang, Yuchong He, Jixiang Chen, Fei Li, Xiaoshuai Gao, Guo Chen, Xin WeiObjective:
To evaluate the safety and efficacy of the Allium metal ureteral stent (AMUS) in treating ureteral stricture (US) in patients with solitary kidney (SK).
Patients and Methods:
We prospectively collected clinical data from 47 SK patients with US who underwent endoscopic AMUS placement between January 2019 and December 2021. Surgical success was defined as in-place AMUS stenting with unobstructed drainage.
Results:
This research included 47 patients with 50 cases of US, achieving successful stent placement in 98.0% of cases. The surgical success rates at 1 week, 1 year, and 2 years postoperatively were 96.0%, 82.0%, and 70.0%, respectively. Long-term postoperative follow-up demonstrated significant reductions in hydronephrosis volume, serum creatinine, and blood urea nitrogen levels compared to preoperative values, with glomerular filtration rate (GFR) maintained at stable levels. Causes of procedural failure during follow-up included stent migration (10.0%), occlusion (6.0%), stone impaction (8.0%), and urinary tract infection (UTI) (4.0%). Complications associated with AMUS placement included pain (12.0%), hematuria (14.0%), UTI (14.0%), and lower urinary tract symptoms (10.0%).
Conclusions:
Two-year follow-up demonstrated that AMUS endoscopic treatment is feasible and potentially effective for US in SK patients, maintaining stable GFR in the short- to medium term. For patients who are unwilling or unsuitable for surgical reconstruction, AMUS serves as an alternative management approach; however, larger sample sizes and longer follow-up periods are needed to validate these findings further.