Initial experience of a novel ureteral silicone-covered metallic mesh stent in malignant ureteric obstruction

Purpose: To investigate initial experiences and outcomes of a retrograde inserted new silicone-covered metallic ureteric stent (Urexel™) for malignant ureteric obstruction. Methods: We reviewed the medical records for 12 consecutive patients who underwent Urexel™ stent placement for malignant ureteric obstruction from March 2020 to March 2021. The Urexel™ stent is a segmental metallic ureteric stent composed of a nitinol mesh covered with a silicone membrane. We evaluated the clinical outcomes and complications of this new metallic ureteric stent. Results: : The mean age of patients was 58.0 ± 9.9 years, and the median follow-up was 4.5 (0.9–12.5) months. One of the 12 patients underwent bilateral stent insertion, Urexel™ stents were placed in a total of 13 ureteral units. There was no technical failure during stent placement. The mean length of obstructions was 10.3 ± 6.5 cm, and the mean length of the stent-indwelled segment of the ureter was 18.9 ± 4.5 cm. Balloon dilation was necessary in 38.5% (5/13 ureter units) of cases. The overall success rate was 76.9% (10/13). Stent migration was the cause of overall treatment failure in all three cases of failure, with elapsed time to failure of 0.9, 2.6, and 12.5 months. Stent migration occurred in three cases. Common complications included persistent pain, acute pyelonephritis, and lower urinary tract symptoms, but they were grade I or II. Conclusions: In this initial series of novel ureteral silicone-covered metallic mesh stents, Urexel™ showed favorable outcomes with a high success rate and acceptable complication rate in malignant ureteric obstructions.