Allium stent as a curative treatment for benign ureteral strictures: Preliminary experience, surgical technique, and functional results

Objectives: To evaluate the effectiveness and safety of the Allium™ ureteral stent as a curative treatment of benign ureteral strictures. Materials and methods: We retrospectively reviewed the electronic database of the two centers of patients who underwent ureteral Allium™ positioning for different types of stenosis (benign or malignant). Between April 2017 and May 2021, 151 patients were treated with the Allium™ stent for ureteral strictures including benign and malignant stenosis. In total, 83 of them met the inclusion criteria for benign ureteral stricture and were included in final analysis. Results: About the etiology of strictures, 79 (95.18%) were secondary to ureteroscopy or impacted stones and 4 (4.82%) were secondary to pelvic surgery. The median operating time was 47.9 ± 15.53 min, and the median length of strictures was 2.51 ± 0.84 (1-4) cm. The median time of follow-up was 18 months (range 1–48 months), the overall success rate was 85.5% (71/83), and no intraoperative or perioperative major complications were recorded. Among patients with failure (12 pts, 14.5%): 10 (83.33%) presented ureteral strictures again; among them, 8/10 were patients with a stricture length between 2 and 4 cm, 2 (16.67%) patients with pyelus–ureteral junction stenosis experienced the migration of the stent. All patients who experienced failure were treated surgically either with a robotic or laparoscopic approach. Conclusions: In our preliminary experience, the Allium™ stent seems to be an effective and safe surgical treatment for benign ureteral stricture. Further analysis and prospective trials are necessary to better define the role of the Allium™ stent in the treatment of benign ureteral strictures.