Use of the Allium stent for management of ureteral pathology: A real-world clinical practice study.

Abstract

Introduction: The objective of the present study was to carry out a real-world clinical practice study, verifying through prospective analysis whether the Allium stent could resolve different types of ureteral pathologies, with strictures of different etiology and cases of urine leakage.

Material and methods: Prospective observational study collecting all cases of Allium ureteral stent placement in our center between 2021 and 2022. Descriptive and comparative analyses were carried out to verify the success rate of Allium stents and pinpoint patient profiles in whom stent implantation would provide effective resolution of stricture or leakage.

Results: A total of 30 Allium stent cases were collected in 30 patients, 10 of which were considered successful procedures (eight cases of stricture and two leakage) while 20 were classed as failures (15 stricture and five ureterointestinal urine leakage). The most frequent pathology was ureterointestinal stricture (33.3%) in patients with an ileal conduit, followed by retroperitoneal fibrosis (26.7%) and ureterointestinal urine leakage (16.7%). Furthermore, up to 40% of the sample had an infectious complication 1 month after stent implantation, while the most common cause of failure was persistent hydronephrosis (36.7%). Notably, only two of the 10 ureterointestinal stricture cases and one of the five cases of ureterointestinal urine leakage were resolved with the stent. Furthermore, a statistically significant relationship was found between the indication of the stent and its success: specifically, all cases of poor tolerance to DJ stents and ureteral urine leakage were resolved (OR: 12.66) with the Allium stent.

Conclusions: The resolution rate of ureteral pathology with the Allium stent is relatively low. The patients who can benefit the most from this device are those with ureteral urine leakage or poor tolerance to the DJ stent. Among the possible complications, urinary infection in the first month after implantation is the most common.