Allium Ureteral Stent as a Treatment for Ureteral Stricture: Results and Concerns

Introduction: Ureteral strictures could be a chronic illness that leads to severe side effects and poor quality of life. A treatment with an Allium ureteral stent (URS), a self-expanding, large-caliber URS, was implemented in our department for ureteral stricture. Our study aim was to report the long-term results, including success rate, complications, and adverse effects. Methods: We retrospectively collected data on all patients who were treated with an Allium URS in our department between January 2017 and January 2021. Demographic, clinical, radiological, and perioperative parameters were retrieved and analyzed. The primary outcome was stricture resolution rates following stent removal. Results: Our cohort included 17 patients, 9 men and 8 women. The etiology of ureteral strictures was urolithiasis in 76.5% and pelvic procedure injury in 17.6%. The overall success rate was 35.29% in an average follow-up of 10.42 ± 2.39 months after stent removal. A higher failure rate was observed in the urolithiasis etiology group (90% vs. 66.7%, p = 0.38). The mean indwelling time of the Allium stent was 14.29 ± 1.29 months. Conclusions: Although an Allium URS could be considered as a feasible and attractive treatment of ureteral strictures, due to its minimal invasiveness, the success rate of this treatment is relatively low. Therefore, this option should be carefully considered and should be discouraged in young and fit patients and reserved for older unfit patients who are unwilling to undergo surgical repair of ureteral strictures.