Abstract
Purpose:
To independently assess upper urinary tract Memokath (MMK-051) stent outcomes in a national tertiary referral center.
Materials and Methods:
Two researchers, completely independent to the treating team, reviewed electronic MMK-051 stent(s) patient management records. Outcomes included time to first complication, complication(s)-severity, MMK-051 stent lifespan and change incidence, salvage therapy, further surgical intervention, and mortality.
Results and Limitations:
One hundred patients received 162 MMK-051 stent(s) (59% with malignant and 63% with distal ureteral obstruction [UO]) with only three lost to follow-up (FU). At 5-year mean FU, only 25 patients had complication-free original MMK-051 stents (14 alive, 11 dead). Of the remaining 75 patients, 22 had other stents, 12 had major surgery (e.g., nephrectomy), 3 became dialysis dependent, and 14 stabilized without ureteral stenting after original MMK-051 removal. Malignant obstruction patients had greater original MMK-051 stent longevity (p < 0.02), but also 20 of the 21 deaths (95%). The 72% mean 5-year stent complication rate included migration (46%), blockage (34%), nonfunctioning kidney (8%), urosepsis needing intravenous antibiotics (8%), and others (6%), including one postoperative death, one ureteral injury, and two with intractable pain. Median time to first complication was 12.5 months.
Conclusions:
MMK-051 stents had optimal utility in managing malignant UO and in those unfit for corrective surgery. Longer independently assessed mean 5-year outcomes review revealed much higher complication rates (72%) than previously reported. Future international metallic ureteral stent guidelines should encourage clinicians to adopt patient-centered multidisciplinary assessment and selection, with counseling plus goal-setting, and harmonized long-term protocol-based reporting, for optimized future patient safety and outcomes.
Get full access to this article
View all access options for this article.
References
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
