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. 2024 Apr 19;103(16):e37765.
doi: 10.1097/MD.0000000000037765.

Migration of double-J ureteral stent in patients with ureteroileal anastomosis stricture undergoing radical cystectomy and orthotopic neobladder: Analysis risk factors of stent migration

Chang Hoon Oh  1 , Soo Buem Cho  2 , Hyo Jeong Lee  1 , Hyeyoung Kwon  3 , Yeok Gu Hwang  4
Affiliations

Migration of double-J ureteral stent in patients with ureteroileal anastomosis stricture undergoing radical cystectomy and orthotopic neobladder: Analysis risk factors of stent migration

Chang Hoon Oh et al. Medicine (Baltimore). .

Abstract

The objective was to evaluate the incidence and degree of double-J ureteral stent (DJUS) migration. Additionally, we aimed to investigate the risk factors associated with stent migration in the orthotopic neobladder group. In this retrospective study, 61 consecutive patients were included; 35 patients (45 DJUS placements) underwent radical cystectomy with orthotopic neobladder and 26 patients (35 DJUS placements) underwent urinary bladder without cystectomy between July 2021 and March 2023. All the patients were treated with a DJUS for ureteric strictures. The technical success rate was 100% in each group. The DJUS migration was significantly higher in the orthotopic neobladder group, with 22 of 45 cases (48.9%), compared to the urinary bladder group, which had 4 of 35 cases (11.4%) (P ≤ .001). Among the patients in the orthotopic neobladder group who experienced DJUS migration, stent dysfunction occurred in 18 cases (81.8%), which was statistically significant (P = .003). Multivariate logistic regression analysis revealed that only the size of the DJUS was significantly and positively associated with migration (odds ratio:10.214, P = .010). DJUS migration can easily occur in patients undergoing radical cystectomy and orthotopic neobladder, and smaller stent sizes are associated with a higher incidence of migration.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Double-J ureteral stent (DJUS) migration type observed abdomen X-ray. (A) Type I: the proximal tip (arrow) of DJUS located at the ureteropelvic junction. (B) Type II: the proximal tip (arrow) of DJUS located at the proximal ureter (arrowhead). (C) Type III: the proximal tip (arrow) of DJUS located at the mid to distal ureter. (D) Type IV: proximal migration of the proximal tip (arrow) of DJUS.
Figure 2.
Figure 2.
Two type of double-J ureteral stents. 8-F Flexima ureteral stent (Boston Scientific, Natick) with side holes (arrow) in the proximal 2-cm of the straight portion without sideholes in the straight portion (upper). 8-F InLay Optima ureteral stent (BD, Tempe) with multiple side holes (arrowhead) in the straight portion and tip of double-J ureteral stent (lower).
Figure 3.
Figure 3.
Flowchart of double-J ureteral stent insertion cases in urinary bladder group and orthotopic neobladder group.
Figure 4.
Figure 4.
Seventy-seven-yr-old man with bladder cancer and undergone radical cystectomy and orthotopic neobladder. (A) Abdomen X-ray obtained just after placement of InLay Optima and showed proper located distal tip (arrow) of double-J ureteral stent (DJUS). (B) In 2 wk after placement of DJUS, abdomen X-ray showed proximal migration of the distal tip (arrowhead) of DJUS near ureteroileal anastomosis site.
See this image and copyright information in PMC

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