genel tıp derg

Genel Tıp Dergisi

2602-3741

Selçuk Üniversitesi

10.54005/geneltip.1764241

Radiology and Organ Imaging

Radyoloji ve Organ Görüntüleme

Antegrade vs. Retrograde Ureteral Stenting for Malignant Obstruction: Clinical Outcomes of a Single-Stage Approach

Malign Obstrüksiyonlarda Antegrad ve Retrograd Üreteral Stentleme: Tek Aşamalı Yaklaşımın Klinik Sonuçları

https://orcid.org/0000-0002-5398-7035

Dilek

İsmail

SELÇUK ÜNİVERSİTESİ, TIP FAKÜLTESİ

https://orcid.org/0000-0002-3686-3874

Gürhan

Abdi

Konya Ereğli Devlet Hastanesi

https://orcid.org/0000-0002-0547-872X

Erol

Seyit

SELÇUK ÜNİVERSİTESİ, TIP FAKÜLTESİ

https://orcid.org/0000-0002-6797-3937

Altıntaş

Emre

SELÇUK ÜNİVERSİTESİ, TIP FAKÜLTESİ

https://orcid.org/0000-0003-3213-8576

Nayman

Alaaddin

SELÇUK ÜNİVERSİTESİ, TIP FAKÜLTESİ

04 07 2026

36 2026 1 7 08 14 2025 09 10 2025

1990

Genel Tıp Dergisi

Aim: Malignant ureteral obstruction (MUO) is a serious complication of advanced-stage malignancies, associated with limited life expectancy and lacking standardized management guidelines. This study aims to compare the technical and clinical success rates, as well as the complication profiles, of retrograde ureteral stenting (RUS) and antegrade ureteral stenting (AUS)—including its single- and multi-stage subtypes—in the treatment of MUO.Materials and Methods: In this retrospective single-center study, 127 patients (155 procedures) who underwent ureteral stenting for MUO between 2019 and 2023 were analyzed. Patients were divided into RUS and AUS groups. AUS procedures were further categorized into single-stage (tubeless) and multi-stage (with protective nephrostomy) subgroups. Technical success, clinical success, complication rates, and etiological data were evaluated and statistically compared.Results: Technical success was significantly higher in the AUS group (97.6%) compared to the RUS group (37.7%) (p < 0.001). No significant difference was found in clinical success between the groups. AUS maintained high technical success regardless of intrinsic or extrinsic etiology. Although single-stage AUS demonstrated a slightly higher clinical success rate, complication and success rates between single- and multi-stage AUS procedures did not differ significantly. No major complications were observed across the AUS subgroups.Conclusions: AUS is a highly effective and safe intervention for MUO, outperforming RUS in terms of technical success. When appropriately selected, single-stage AUS offers a less invasive and cost-effective alternative without compromising outcomes. These findings support the broader implementation of single-stage AUS as a first-line option in the management of MUO.

Amaç: Malign üreteral obstrüksiyon (MÜO), ileri evre malignitelerin ciddi bir komplikasyonu olup, sınırlı yaşam beklentisi ile ilişkilidir ve standart yönetim kılavuzları bulunmamaktadır. Bu çalışmada, MÜO tedavisinde retrograd üreteral stentleme (RÜS) ile antegrad üreteral stentlemenin (AÜS) — tek aşamalı ve çok aşamalı alt tipleri dâhil — teknik ve klinik başarı oranları ile komplikasyon profillerinin karşılaştırılması amaçlanmıştır.Gereç ve Yöntemler: Bu retrospektif, tek merkezli çalışmada, 2019–2023 yılları arasında MÜO nedeniyle üreteral stentleme yapılan 127 hasta (155 işlem) incelendi. Hastalar RÜS ve AÜS gruplarına ayrıldı. AÜS işlemleri, tek aşamalı (tüpsüz) ve çok aşamalı (koruyucu nefrostomili) alt gruplara sınıflandırıldı. Teknik başarı, klinik başarı, komplikasyon oranları ve etyolojik veriler değerlendirildi ve istatistiksel olarak karşılaştırıldı.Bulgular: Teknik başarı oranı, AÜS grubunda (%97,6) RÜS grubuna (%37,7) kıyasla anlamlı derecede yüksekti (p < 0,001). Gruplar arasında klinik başarı açısından anlamlı fark bulunmadı. AÜS, intrinsik veya ekstrinsik etiyolojiden bağımsız olarak yüksek teknik başarı oranını korudu. Tek aşamalı AÜS, klinik başarı açısından biraz daha yüksek oran gösterse de tek ve çok aşamalı AÜS prosedürleri arasında komplikasyon ve başarı oranlarında anlamlı fark saptanmadı. AÜS alt gruplarında majör komplikasyona rastlanmadı.Sonuçlar: AÜS, MÜO tedavisinde teknik başarı açısından RÜS’ye üstün, etkili ve güvenli birgirişimdir. Uygun hasta seçimi yapıldığında tek aşamalı AÜS, sonuçlardan ödün vermeden daha az invaziv ve maliyet etkin bir alternatif sunar. Bulgular, MÜO yönetiminde tek aşamalı AÜS’nin birinci basamak seçenek olarak daha yaygın uygulanmasını desteklemektedir.

Malignant ureteral obstruction Nephrostomy Antegrade ureteral stenting Retrograde ureteral stenting Single-stage procedure

Malign üreteral obstrüksiyon Nefrostomi Antegrad üreteral stentleme Retrograd üreteral stentleme Tek aşamalı prosedür

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