Can preoperative ureteral stents reduce the incidence of ureteral stricture after radiotherapy in patients with cervical cancer?

BMC Urol. 2022 Jul 18;22(1):106. doi: 10.1186/s12894-022-01029-0.

Abstract

Objective: To determine the impact of preoperative stent placement on postradiotherapy stricture rate in patients with cervical cancer after radical resection.

Methods: This study was a retrospective analysis of data collected from 55 cervical cancer patients treated with radiotherapy between June 2016 and June 2020. Patients were divided into the stent and control groups. After 3 months, the stricture rate and the complications related to stent placement between the two groups were compared.

Results: There were 12 (46.2%) and 10 (34.5%) cases of ureteral stricture in the stent (n = 26) and control (n = 29) groups, respectively, three months after the end of radiotherapy. The incidence rates of ureter stricture in the two groups were not significantly different (P = 0.378). Moreover, there were 20 units (38.5%) and 15 units (25.9%) ureteral strictures in the stent and control groups, respectively. No significant difference in the incidence rates of ureteral strictures was found between the two groups (P = 0.157). There were 13 (50.0%) and 10 (34.5%) cases of ureteral stricture in the stent (n = 26) and control (n = 29) groups, respectively, six months after the end of the radiotherapy. The incidence rates of ureter stricture in the two groups were not significantly different (P = 0.244). Moreover, there were 21 units (40.4%) and 15 units (25.9%) ureteral strictures in the stent and control groups, respectively. No significant difference in the incidence rates of ureteral strictures was found between the two groups (P = 0.105). Complications related to stent placement such as urinary tract infections and bladder irritation were statistically significant (P = 0.006 and P = 0.036) between the two groups; while the other complications were not significantly different (P = 0.070, P = 0.092 and P = 0.586).

Conclusions: Ureteral stents may not reduce the incidence of ureteral stricture after radiotherapy in patients with cervical cancer. The stent needs to be replaced regularly, and the complications related to stent placement may occur at any time. Thus, preoperative stent placement should be cautious for the clinical management of cervical cancer patients treated with postoperative radiotherapy.

Keywords: Cervical neoplasms; Preoperative stent placement; Radiotherapy; Ureteral Stents; Ureteral stricture.

MeSH terms

  • Constriction, Pathologic / complications
  • Constriction, Pathologic / etiology
  • Female
  • Humans
  • Incidence
  • Retrospective Studies
  • Stents / adverse effects
  • Ureter* / surgery
  • Ureteral Obstruction* / epidemiology
  • Ureteral Obstruction* / etiology
  • Ureteral Obstruction* / surgery
  • Uterine Cervical Neoplasms* / radiotherapy
  • Uterine Cervical Neoplasms* / surgery