Document Detail

Resonance Metallic Stents Do Not Effectively Relieve Extrinsic Ureteral Compression in Pediatric Patients.
MedLine Citation:
PMID:  22998392     Owner:  NLM     Status:  Publisher    
Use of metallic stents (Resonance) has been reported in the literature to be effective in relieving extrinsic obstruction in adults. Successful patency rates have been reported to be around 83.3%. The use of Resonance stents in children has not been reported. We present our experience with these stents in addressing extrinsic ureteral obstruction in the pediatric population. We identified two patients who underwent placement of Resonance stents for extrinsic compression at the Children's Hospital of the University of Pittsburgh Medical Center. The first patient is a 12 y/o female a solitary left kidney diagnosed with pelvic rhabdomyosarcoma; treated with surgery followed by adjuvant chemoradiation. Two years post treatment she developed worsening renal function secondary to ureteral strictures. The second patient is a 14 y/o female with a history of Gardner syndrome. She developed recurrent desmoid tumors in her pelvis and retroperitoneum that led to right ureteral obstruction; necessitating a nephrostomy tube. Both patients underwent successful technical placement of a Resonance stent. The time to failure for patient #1 was 3 months and for patient #2, 3 weeks. The first patient presented to the ED, 3 months post stent in renal failure with Cr of 13.7 mg/dL. This required nephrostomy tube placement and hemodialysis. Ultimately, she required an ileal ureter to preserve renal function. She is off hemodialysis and has a Cr of 2.2 The second patient developed recurrent episodes of pyelonephritis, worsening hydronephrosis, and flank pain with just the resonance stent in place. It was elected to remove the resonance stent and replace the nephrostomy tube. She required extensive ureterolysis, a right subtotal ureterectomy with a right to left ureteroureterostomy. We did not find the use of these stents to be effective in children. The time to failure was significantly shorter in children than those reported in the literature for adults.
Bishoy A Gayed; Abhijith D Mally; Julie M Riley; Michael C Ost
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-21
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  -     ISSN:  1557-900X     ISO Abbreviation:  J. Endourol.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
University of Pittsburgh, Urology, 3471 5th Ave, Suite 700 Kaufmann Bldg, Pittsburgh, Pennsylvania, United States, 15213;
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