Ante-grade ureteric stenting, retrospective experience in managing 89 patients: Indications, complications and outcome

Abstract

Background: Over the past three decades there has been a remarkable increase in interventional uro-radiological procedures in the developed countries. Long-term drainage of the obstructed upper urinary tract may be achieved by percutaneous nephrostomy or ureteric stenting. Previously most ureteric stents were inserted by the retrograde approach at cystoscopy and these procedures have required the use of general or spinal anesthesia. With the development of a nephrostomy service in most hospitals throughout the world ante-grade ureteric stenting procedures are being carried out by trained interventional radiologists in the radiology department without the need for a general or spinal anesthesia.

Aims/materials and methods: To review the records of all 89 patients who had insertion of ante-grade ureteric stents
for ureteric obstruction between February 2010 and January 2013 in order to document the following: The causes of obstruction; The side (left, right or both sides) and site of the ureteric obstruction (upper, mid or lower ureter); The sex
and ages of the patients; Success or failure of the procedure; Complications of procedure; The management of the complications.

Results: Ante-grade ureteric stenting was successful in 105 out of 121 procedures (86.7%) which 89 patients underwent. Out of 105 successful ante-grade stenting procedures carried out, 103 were successful at first attempt, another two were successful at second attempt and one successful at a third attempt, making it a total of 105 successful procedures. There were minimal complications.

Conclusion and recommendation: Ante-grade ureteric stenting is a safe procedure with minimal complications. Every radiology unit should have a trained interventional radiologist capable of performing ante-grade ureteric stenting.