Conventional polymeric ureteric stenting for the long term management of chronic ureteric obstruction. A service evaluation study
Author(s):
Mr Saifeldin Elamin
,
Mr Saifeldin Elamin
Affiliations:
Dr Adnan Ahmad
,
Dr Adnan Ahmad
Affiliations:
Dr Louise Linley-Adams
,
Dr Louise Linley-Adams
Affiliations:
Mr Hrishi Joshi
Mr Hrishi Joshi
Affiliations:
BAUS ePoster online library. Ahmad A. 06/26/17; 177350; P2-4
Mr. Adnan Ahmad
Mr. Adnan Ahmad
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Abstract
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Objectives
Short term polymeric ureteric stents are used in management of chronic ureteric obstruction. We evaluated outcomes and cost of retrograde ureteric stenting (RUS) in patients with chronic ureteric obstruction.

Methods
We reviewed clinical data of patients who underwent RUS between January 2013 - October 2016. Patients who underwent multiple RUS for the long term treatment of obstruction were included. We recorded the number of stent changes, length of stay, complications, patient survival and cost analysis using tariffs.

Results
41 patients underwent multiple RUS for chronic ureteric obstruction. 29 (71%) had malignant ureteric obstruction (MUO) compared to 12 (29%) who had a benign cause. MUO was most commonly caused by bowel (n=9, 22%), cervical (n=7, 17%) and prostate cancer (n=5, 12%) whereas retroperitoneal fibrosis was the most common benign cause (n=4, 10%).

6 patients (15%) developed complications requiring additional treatments (stent failure n=5, urosepsis n=1).

The median number of stent changes was 3 (range 1-9).
Average hospital stay was 3.5 days (range 1-28 days).
13 patients (32%) died during the 3 year period (MUO group)
Average time to death from time of first insertion was 20.2 months (range 8-34).
Inclusive of theatre time, equipment, staff, average length of stay per stent change and median number of stent changes, multiple polymeric RUS would cost £6000 per year per patient.

Conclusions:
Polymeric RUS offers a temporary solution with significant cost and morbidity. Our results provide a framework to evaluate current services and compare it with alternative management options including metal based stents.
Objectives
Short term polymeric ureteric stents are used in management of chronic ureteric obstruction. We evaluated outcomes and cost of retrograde ureteric stenting (RUS) in patients with chronic ureteric obstruction.

Methods
We reviewed clinical data of patients who underwent RUS between January 2013 - October 2016. Patients who underwent multiple RUS for the long term treatment of obstruction were included. We recorded the number of stent changes, length of stay, complications, patient survival and cost analysis using tariffs.

Results
41 patients underwent multiple RUS for chronic ureteric obstruction. 29 (71%) had malignant ureteric obstruction (MUO) compared to 12 (29%) who had a benign cause. MUO was most commonly caused by bowel (n=9, 22%), cervical (n=7, 17%) and prostate cancer (n=5, 12%) whereas retroperitoneal fibrosis was the most common benign cause (n=4, 10%).

6 patients (15%) developed complications requiring additional treatments (stent failure n=5, urosepsis n=1).

The median number of stent changes was 3 (range 1-9).
Average hospital stay was 3.5 days (range 1-28 days).
13 patients (32%) died during the 3 year period (MUO group)
Average time to death from time of first insertion was 20.2 months (range 8-34).
Inclusive of theatre time, equipment, staff, average length of stay per stent change and median number of stent changes, multiple polymeric RUS would cost £6000 per year per patient.

Conclusions:
Polymeric RUS offers a temporary solution with significant cost and morbidity. Our results provide a framework to evaluate current services and compare it with alternative management options including metal based stents.
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