Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2020; 8(13): 2841-2848
Published online Jul 6, 2020. doi: 10.12998/wjcc.v8.i13.2841
Metallic ureteral stent in restoring kidney function: Nine case reports
Wei Gao, Tong-Wen Ou, Xin Cui, Jiang-Tao Wu, Bo Cui
Wei Gao, Tong-Wen Ou, Xin Cui, Jiang-Tao Wu, Bo Cui, Department of Urology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
Author contributions: Gao W, Ou TW, Cui X, Wu JT and Cui B conducted the clinical study; Gao W and Ou TW were responsible for the integrity of the entire study; Gao W contributed to study concept, design, data collection, data management, interpretation and supervision and statistical analysis and drafted the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Wei Gao, MD, Associate Chief Physician, Department of Urology, Xuanwu Hospital, Capital Medical University, Changchun Street No. 45, Xicheng District, Beijing 100053, China. polarbeargaowei@sina.com
Received: December 23, 2019
Peer-review started: December 23, 2019
First decision: March 5, 2020
Revised: May 12, 2020
Accepted: June 7, 2020
Article in press: June 7, 2020
Published online: July 6, 2020
Abstract
BACKGROUND

Retroperitoneal fibrosis is an exceptionally rare disease characterized by proliferation of fibrous tissue and inflammation in the retroperitoneum. It features many symptoms in the kidneys and in other organs and usually leads to ureteral obstruction.

CASE SUMMARY

Here we present 9 consecutive cases of idiopathic retroperitoneal fibrosis (IRPF) in patients who presented to the Department of Nephrology or Department of Rheumatology, Xuanwu Hospital, Capital Medical University, Beijing, China, between January 2012 and June 2017 with ureteral obstruction due to external compression of the ureter that led to hydronephrosis and kidney dysfunction. Computed tomography imaging was used to identify hydronephrosis and ureteral obstruction and to evaluate kidney function. Each patient was diagnosed with IRPF based on clinical observation and computed tomography examination results. To restore kidney function, a retrograde metallic stent was placed in the ureter under X-ray guidance 2 d after each patient’s admission. No perioperative complications occurred in any patient, but postoperative complications occurred in two patients as follows: Patient 2 had stent migration and repeated metallic stent infections that resolved with treatment; and patient 4 had postoperative hematuria because he resumed normal activities too soon after stent placement (contrary to instruction). Placement of the metallic ureteral stents provided relief from ureteral obstruction and restored kidney function in all patients.

CONCLUSION

Our 9-case series underscores the utility and efficacy of applying the Resonance® metallic ureteral stent to treat ureteral obstruction in patients with IRPF. For all retroperitoneal fibrosis cases in our series, ureteral stents provided effective relief and were shown to reduce the incidence rate of perioperative and postoperative complications.

Keywords: Retroperitoneal fibrosis, Metallic ureteral stent, Ureteral obstruction, Computed tomography, Kidney function, Plastic stent, Case report

Core tip: Nine patients with idiopathic retroperitoneal fibrosis admitted to our institution within a 5-year period received Resonance® metallic stents to restore kidney function. Ureteral obstruction was relieved in all 9 cases, and only 2 patients experienced adverse effects (stent migration and repeated metallic stent infection in one patient and postoperative hematuria in another). Overall, these stents demonstrated effective relief and resulted in fewer complications in the treatment of ureteral stenosis in patients with idiopathic retroperitoneal fibrosis.