Evaluation of the Use of Long Term DJ Stents in Ureteral Obstructions That Cannot Be Treated Curatively

Year 2024, Volume: 16 Issue: 2, 64 - 69, 31.05.2024

Özgür Arıkan , Ilkın Hamıdzada , Ferhat Keser , Mustafa Kaan Akalın , Özgür Efiloğlu , Asıf Yıldırım

https://doi.org/10.54233/endourolbull-1471001

Abstract

Objective: Ureteral obstructions may develop due to intrinsic or extrinsic, benign or malignant etiology and may cause loss of renal function, pain and recurrent urinary system diseases. Curative treatments for etiology are not always possible. We aimed to evaluate the clearance and salvage of this long term DJ stent, which has effective ureteral obstruction but can not be performed with curative surgery.
Material and Methods: 131 patients who underwent long term DJ stent application due to ureteral obstruction between 2015 and 2022 were followed up and evaluated retrospectively. Demographic data of the patients, ureteral obstruction etiology, follow-up period and complications were recorded. The 4.8F-26cm, Boston Percuflex™Plus Ureteral Stent was used in the patients and was planned to be replaced once a year.
Results: Of the 131 patients included in this study, 40 (30.53%) had malignant ureteral obstruction and 91 (69.47%) had benign ureteral obstruction. The average follow-up period was found to be 35.4 months. During their follow-up, 18 (13.74%) patients had symptoms such as stent related pain and dysuria, 11 (8.39%) had recurrent urinary tract infection, 8 (6.1%) had encrusted DJ stents, 3 (2.29%) had DJ stent migration and hematuria that requiring blood transfusion was observed in 1 (0.76%) patient.
Conclusions: Our study showed that the use of long term ureteral DJ stent is a safe and effective option in malignant and benign ureteral obstructions.

Keywords

Ureteral obstruction, Long term DJ stent, Curative surgery

Küratif Tedavi Yapılamayan Üreteral Obstrüksiyonlarda Uzun Ömürlü DJ Stent Kullanımının Değerlendirilmesi

Abstract

Amaç: Üreteral obstrüksiyon intrensek veya ekstrensek ayrıca benign veya malign etyolojiye bağlı olarak gelişebilmekte ve renal fonksiyon kaybına, ağrı ve nüks üriner sistem enfeksiyonlarına sebep olabilmektedir. Etyolojiye yönelik küratif cerrahi tedaviler her zaman mümkün olmamaktadır. Bu çalışmada üreteral obstrüksiyonu olan ancak küratif cerrahi yapılamayan hastalarda uzun ömürlü DJ stent kullanımının etkinliğini ve güvenilirliğini araştırmayı amaçladık.
Gereç ve Yöntemler: İstanbul Medeniyet Üniversitesi Göztepe Prof. Dr. Süleyman Yalçın Şehir Hastanesi Üroloji Kliniği’nde 2015-2022 yılları arasında üreteral obstrüksiyon nedeniyle uzun ömürlü DJ stent uygulaması yapılan ve bu şekilde takip edilen 131 hasta retrospektif olarak değerlendirildi. Hastaların demografik verileri, üreteral obstrüksiyon etyolojisi, takip süresi ve komplikasyonları kaydedildi. Hastalara 4,8F-26cm, Boston Percuflex™Plus üreteral stent kullanıldı ve yılda bir kez değiştirilmesi planlandı.
Bulgular: Çalışmaya dahil edilen 131 hastanın 40’ında (%30,53) malign üreteral obstrüksiyon, 91’inde (%69,47) ise benign üreteral obstrüksiyon mevcuttu. Ortalama takip süresi 35,4 ay olarak bulundu. Takipleri süresince 18 (%13,74) hastada stent ilişkili ağrı, dizüri gibi semptomlar, 11 (%8,39) hastada tekrarlayan üriner sistem enfeksiyonu, 8 (%6,1) hastada enkruste DJ stent, 3 (%2,29) hastada DJ stent migrasyonu ve 1 (%0,76) hastada ise kan transfüzyonu gerektiren hematüri geliştiği görülmüştür.
Sonuç: Çalışmamızda gösterilmiştir ki, uzun ömürlü üreteral DJ stent kullanımı, malign ve benign üreteral obstrüksiyonlarda güvenilir ve etkin bir seçenektir.

Keywords

üreteral obstrüksiyon, uzun ömürlü dj stent, küratif cerrahi

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