Indwelling double-J ureteral stents for temporary and permanent urinary drainage: experience with 87 patients.

Indwelling ureteral stents are a useful addition to the urologic armamentarium. The current double-J ureteral stent offers the advantages of ease of endoscopic insertion, exceptional patient tolerance and improved resistance to incrustation. We used these stents in 87 patients: to bypass obstruction in 57, as an adjunct to complicated upper tract surgery in 15, as initial treatment of upper urinary fistulas in 10 and for miscellaneous reasons in 5. The majority of the stents were placed endoscopically (58 per cent) and under local anesthesia (54 per cent). Half of the urinary fistulas healed without an operation and none of the patients treated with stents for malignant obstruction was hospitalized for more than 4 days. The stents were changed easily on an outpatient basis under local anesthesia and patient tolerance was excellent. When used as adjuncts to open procedures the stents frequently allowed for shorter hospital stay, since postoperative urinary drainage was decreased markedly. Of the 136 stents used in our series 13 became obstructed, usually after they were indwelling for more than 8 weeks. Irritative symptoms were noted in only 6 patients and responded well to pharmacologic therapy. We have found the double-J ureteral stent useful and reliable in patients with ureteral obstruction, as adjuncts to genitourinary surgery in selected instances and as internal diversion for upper urinary tract fistulas.