Endoscopic treatment strategies for ureteral stricture in patient with single kidney: triple-stent and metal ureteral stent.

PURPOSE: To evaluate the safety and feasibility of triple Double-J (DJ) stents and Allium metal ureteral stents (AMUS) for treating ureteral strictures (US) in solitary kidney (SK) patients.

METHODS

We prospectively collected clinical data from 100 patients with SK who underwent triple stent or AMUS treatment for US at our center between January 2019 and March 2022. During follow-up, we evaluated surgical success rates, changes in renal function parameters, and the incidence of complications.

RESULTS

100 patients freely chose their treatment methods based on their own medical preferences and financial circumstances. During the 1-year follow-up period, the overall success rates for triple-stent treatment (58 renal units) and AMUS treatment (53 renal units) were similar (79.3% vs. 81.1%, p = 0.81). Although the triple-stent group showed a numerically higher trend in pain (7.5% vs. 12.1%, p = 0.532), hematuria (5.7% vs. 8.6%, p = 0.719), urinary tract infection (UTI) (7.5% vs. 13.8%, p = 0.366), and lower urinary tract symptoms (LUTS) (5.7% vs. 8.6%, p = 0.719), the two groups exhibited statistically comparable incidences of surgical complications. The one-year total cost for triple-stent treatment was only 63.1% of the AMUS treatment group ($9,099.0 vs. $14,411.0, p < 0.001). One year after surgery, the two groups showed similar outcomes, with significant improvements in hydronephrosis, serum creatinine, and blood urea nitrogen levels, and maintained effective renal function.

CONCLUSIONS

Our center has innovatively presented the triple-stent strategy for treating US in patients with SK. A one-year follow-up demonstrated that both triple-stent and AMUS treatments effectively and safely managed US in SK patients. During the short-term follow-up period, the triple-stent group offered greater economic advantages.

CLINICAL TRIAL REGISTRATION: Name of the registry: Research Registry, Registration identifier: researchregistry7266, Hyperlink to your specific registration: https://www.researchregistry.com .