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Ureteral Stenting

Chapter 23: Table of Contents

Ureteral Stenting

In dogs, ureteral stenting is the option of choice for ureteral calculi that cannot be removed easily by ureterotomy.  Ureteral stenting is also frequently performed following ureterotomy or ureteral anastomosis to reduce the risk of ureteral stricture from developing. 

Ureteral stents

Ureteral stenting represents a viable option in cats and has been shown to compare favorably to surgical options with good outcomes. (Nicoli 2012, Berent 2014, Manasssero 2014)  Complications such as stranguria or pollakiuria (48%), and hematuria (52%) were most common in cats of a recent study. (Deroy et al. 2017) Flank pain (23%) is also a newly reported complication. Stent encrustation (26%) causing reobstruction is also reported. (Deroy et al. 2017) Perioperative urine leakage (uroabdomen) occurred in 18% of cats in a recent study. (Deroy 2017)  Stent migration is also a possible complication. (Berent et al. 2014)

Ureteral stenting can be performed by open laparotomy (cats and dogs) or minimally invasively using either fluoroscopic guidance through a nephrostomy (antegrade) approach, or via cystoscopy (retrograde) approach in female dogs. 

Though stents have established benefits in the treatment of ureteral obstruction (Berent 2011), superior outcomes and reduced complications were recently reported in a retrospective study comparing cats undergoing SUB versus ureteral stenting. (Deroy et al. 2017)  

< Surgeries of the Upper Urinary Tract Subcutaneous Ureteral Bypass >

References:

Berent AC, Weisse CW, Todd K. et al. Technical and clinical outcomes of ureteral stenting in cats with benign ureteral obstruction: 69 cases (2006-2010). JAVMA 2014; 244:559-576.

Deroy C, Rossetti D, Ragetly G, et al. Comparison between double-pigtail ureteral stents and ureteral bypass devices for treatment of ureterolithiasis in cats.  JAVMA 2017; 251:429-437.

Nicoli S, Morello E, Marano M, et al. Double-J ureteral stenting in nine cats with ureteral obstruction. Vet J 2012; 194:60-65.

Manassero M, Decambron A, Viateau V, et al. Indwelling double pigtail ureteral stent combined or not with surgery for feline ureterolithiasis: complications and outcome in 15 cases.  J Fel Med Surg 2014; 16:623-630.