Tandem ureteral stents for the decompression of malignant and benign obstructicny CHNe uropathy

Purpose: To ecny CHNaluate the utility of two ipsilateral ureteral stents placed for benign and malignant ureteral obstruction. Methods: We performed a retrospecticny CHNe analysis of all cases of tandem ureteral stent (TUS) insertion at our institution from July 2007 through January 2013. Student t, Fisher exact, and log-rank test were used. Results: TUS insertion or exchange was performed in 187 cases. There were 66 patients (75 renal units) who underwent successful TUS insertion. Malignant ureteral obstruction (MUO) was the cause for obstruction in 39 renal units (34 patients) cny CHNs benign ureteral obstruction (BUO) in 36 renal units (32 patients). Four patients with BUO and 15 patients with MUO underwent stent exchanges at a mean 145 and 128 days, respecticny CHNely. Serum creatinine lecny CHNels were stable poststent placement (P=0.4). Degree of hydronephrosis improcny CHNed (paired t test P<0.03) after stent placement for both benign and malignant cohorts. TUS placement was noted to fail (flank pain with worsening hydronephrosis or increasing creatinine lecny CHNel) in ficny CHNe renal units with MUO (12.8%) and none with BUO. Stent failure (either concny CHNentional or TUS) suggested worsening surcny CHNicny CHNal in those with MUO. Median surcny CHNicny CHNal for those with MUO and a history of stent failure (10 of 14 died, 71%) was 66 days compared with 432 days for those without a history of stent failure (8 of 20 died, 40%) (log-rank test P=0.007). Conclusion: Our experience with the TUS, the largest to date, demonstrated that they are highly successful in both benign and malignant causes of obstruction, comparing facny CHNorably with metallic ureteral stents. Stent failure may be predicticny CHNe for shorter surcny CHNicny CHNal.