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Covered Metal Ureteral Stents in the Treatment of Benign Short Ureteral Stricture

Not Applicable
Not yet recruiting
Conditions
Ureteral Stenosis
Interventions
Device: Covered metal ureteral stents
Device: Tandem DJ stents
Registration Number
NCT05430646
Lead Sponsor
Peking University People's Hospital
Brief Summary

BSUS patients were prospectively enrolled in this study, and non-randomly treated with "balloon dilation +CMUS" and "balloon dilation + tandem DJ stent". Perioperative data of the patients were recorded to compare their efficacy and complications, and the ureteral stent symptom questionnaire was used to compare their impact on patients' quality of life. CMUS and tandem DJ stents were removed after ≥3 months of indwelling. After the removal of stents, the patients' serum creatinine and renal pelvis width were followed up to compare their curative effect on BSUS.

Detailed Description

The ureteral stricture is caused by various benign and malignant reasons, and then appears hydronephrosis and progressive decline of renal function. Benign short ureteral stenosis (BSUS) especially refers to ureteral stenosis of no more than 2cm in length caused by benign causes such as impacted ureteral stone or endoscopic lithotomy. Currently, BSUS can be treated with laparoscopic or open ureteroplasty, endoscopic balloon dilation or ureterotomy, ureteral stents insertion, or nephrostomy. Since its introduction, covered metal ureteral stent (CMUS) can be used to treat various types of ureteral stricture, achieving a long-term patency rate of more than 80% for BSUS and even curing some patients. It also has fewer complications than a double-J stent (DJ stent). However, there is still a lack of comparative studies on the therapeutic effect and complications of the two treatment methods, namely CMUS after balloon dilation and tandem DJ stent, for BSUS, especially the evaluation of the curative effect of BSUS. Therefore, BSUS patients were prospectively enrolled in this study, and non-randomly treated with "balloon dilation +CMUS" and "balloon dilation + tandem DJ stent". Perioperative data of the patients were recorded to compare their efficacy and complications, and the ureteral stent symptom questionnaire was used to compare their impact on patients' quality of life. CMUS and tandem DJ stents were removed after ≥3 months of indwelling. After the removal of stents, the patients' serum creatinine and renal pelvis width were followed up to compare their curative effect on BSUS.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
100
Inclusion Criteria
  • BSUS patients from January 2023 to January 2024 in Peking University People's Hospital, no gender limitation, aged from 18 to 80, Benign ureteral stricture with definite reason (ureteropelvic junction obstruction, ischemic ureter stenosis caused by surgical separation, ureter partial excision anastomosis stricture after operation, ureteral stricture caused by ureteral endoscope surgery, ureteral stenosis caused by impacted ureteral calculi, ureteral anastomotic stricture after urinary flow diversion, ureteral anastomotic stricture after kidney transplantation, retroperitoneal fibrosis, ureteral stricture caused by trauma, idiopathic ureteral stricture), patients can tolerate anesthesia and surgery and obtain informed consent.
Exclusion Criteria
  • Patients with hypertonic neurogenic bladder, severe bladder outlet obstruction or bladder capacity less than 50ml, combined with sepsis, incomplete clinical data, failed stent implantation, insufficient indwelling time (< 3 months), postoperative loss of follow-up.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
CMUS groupCovered metal ureteral stentsBalloon dilatation and CMUS insertion were performed in this group.
Tandem DJ stent groupTandem DJ stentsBalloon dilatation and Tandem DJ stent insertion were performed in this group.
Primary Outcome Measures
NameTimeMethod
Ureteral stent symptom questionnaire (USSQ)Postoperative 3-month

USSQ represents for the quality of life of patients with ureteral stents.

Serum Creatinine (SCr) after stent removalThree-month after stent removal

It represents for the curative effect of balloon dilatation and ureteral stent.

Postoperative Serum Creatinine (SCr)Postoperative 3-month

It represents for the renal function change after ureteral stent insertion.

Postoperative Renal pelvic width (RPW)Postoperative 3-month

It represents for the change of hydronephrosis after ureteral stent insertion.

Renal pelvic width (RPW) after stent removalThree-month after stent removal

It represents for the curative effect of balloon dilatation and ureteral stent.

Secondary Outcome Measures
NameTimeMethod
ComplicationsPostoperative 3-month

Ureteral stent related complications

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