Allium® ureteral stent for benign ureteral stricture: a case report and concise literature review.

BACKGROUND: Ureteral strictures are a potentially obstructive condition that, if left untreated, may progress to chronic kidney disease. The leading cause is iatrogenic, most commonly following endourological surgery or gynecological procedures. While reconstructive surgery-either open or robotic-remains the gold standard, endourological stents represent a viable alternative in many cases.

CASE PRESENTATION: We report the case of a 54-year-old woman who sustained an iatrogenic complete transection of the distal right ureter during myomectomy. Initial management included percutaneous nephrostomy and delayed open ureteral reconstruction using a Boari flap. Postoperative complications included stent dislocation and partial anastomotic dehiscence, necessitating revision surgery. Despite these interventions, the patient developed a recurrent distal ureteral stricture with persistent symptoms and stent intolerance. As a minimally invasive alternative, an Allium® self-expanding ureteral stent (Allium Ltd., Caesarea, Israel) was placed endoscopically. The patient experienced marked clinical improvement, stable renal function, and no major complications such as migration or encrustation. A localized inflammatory reaction at the stent contact zone was identified upon follow-up ureteroscopy, with biopsy confirming chronic inflammation.

CONCLUSION: The Allium® ureteral stent represents a safe, effective, and well-tolerated option for managing complex recurrent ureteral strictures in patients who are poor candidates for, or unwilling to undergo, surgical reconstruction. This case illustrates the stent's potential to preserve renal function and improve patient quality of life while minimizing the need for frequent interventions. Careful patient selection and regular endoscopic follow-up are critical to optimizing outcomes.