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• W3019758256 abstract "The article by Tabib et al. summarized ureteral stenosis that developed from malignant diseases, and reviewed previous studies on ureteral stenting or nephrostomy for patients with malignant ureteral obstruction (MUO).1 Since Zimskind et al. first reported ureteral stents in 1967, various types have come into clinical use.2 Recently, a metallic-type ureteral stent was approved, enabling longer duration stenting.3 However, despite the efficacy of metallic ureteral stents for treating MUO, more than a few patients have developed stent failure.4 The authors described previous studies, discussed differences among several types of ureteral stents and suggested approaches to managing ureteral stenting for MUO. After ureteral stent failure, percutaneous nephrostomy is an option for MUO. However, in severe MUO patients with advanced malignant diseases, nephrostomy significantly reduces the quality of life. We previously reported a case in which a metallic ureteral stent was inserted through an antegrade approach after nephrostomy, with the nephrostomy successfully removed.5 For advanced malignant patients, fewer external tubes, less-invasive procedures and a reduction in the rate of ureteral stent-related symptoms are required. The present findings are expected to help urologists choose which ureteral stent type is ideal for individual MUO patients, and the authors weighted the importance of preserving the patient quality of life in relation to ureteral stenting. Regarding concerns about ureteral stent-related symptoms, although various types of ureteral stents have been introduced, such as soft-material types or types with a loop at the distal end, and trials have been carried out for some medication to decrease ureteral stent-related symptoms, such as anticholinergics or alpha-1 blockers, the best and simplest way to decrease symptoms involves choosing the appropriate length of ureteral stent.6 We carried out a web-based questionnaire in 200 healthy Asian-Japanese adult women regarding their urgency distress. The questionnaire asked, “How much would you pay per day to reduce the urinary urgency associated with ureteral stenting when you were in advanced malignant disease and have to be ureteral stented?” The mean value was ¥300 (approximately US$2.8) per day. In Japan, the ureteral stent market size is thought to be nearly 220 000 stents per year. If patients have their ureteral stent changed every 3 months, this amounts to approximately 55 000 patients per year undergoing ureteral stenting. The surveyed individuals therefore placed a value of approximately ¥6 billion (approximately US$56 million) per year to reduce their symptoms. For benign ureteral stenosis patients, managing the condition without the need for ureteral stenting is important. However, for MUO patients, reducing stent-related symptoms and stent-related complications is most important. Urologists should keep in mind that choosing the appropriate type and length of ureteral stent is required to improve the quality of life for MUO patients. None declared." @default.
• W3019758256 created "2020-05-01" @default.
• W3019758256 creator A5011955308 @default.
• W3019758256 date "2020-04-28" @default.
• W3019758256 modified "2023-09-27" @default.
• W3019758256 title "Editorial Comment to Management and treatment options when facing malignant ureteral obstruction" @default.
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• W3019758256 doi "https://doi.org/10.1111/iju.14254" @default.
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