European Radiology

, Volume 29, Issue 2, pp 628–635 | Cite as

Comparison of single and tandem ureteral stenting for malignant ureteral obstruction: a prospective study of 104 patients

  • Kao-Lang Liu
  • Bo-Ching LeeEmail author
  • Jian-De Ye
  • Yu-Hsuan Chang
  • Chin-Chen Chang
  • Kuo-How Huang
  • Yuan-Ju Lee
  • Yeun-Chung Chang



The aim of this study was to compare single and tandem ureteral stenting in the management of malignant ureteral obstruction (MUO).


Our hospital’s institutional review board approved this prospective study. Between November 2014 and June 2017, single ureteral stenting was performed in 56 patients (94 renal units) and tandem ureteral stenting in 48 patients (63 renal units) for MUO. A comparative analysis of the technical success rate, patient survival, stent patency, and complications was performed.


Similar demographic data were observed in patients receiving either single or tandem ureteral stenting. The technical success rate was 93.6% (88/94) for single ureteral stenting and 95.2% (60/63) for tandem ureteral stenting. There was no difference in overall survival between patients receiving single or tandem ureteral stenting (p = 0.41), but the duration of stent patency in tandem ureteral stenting was significantly longer (p = 0.022). The mean patency time was 176.7 ± 21.3 days for single ureteral stenting, and 214.7 ± 21.0 days for tandem ureteral stenting. The complications of ureteral stenting were urinary tract infection (n = 18), lower urinary tract symptoms (n = 5), haematuria (n = 3), and stent migration (n = 1).


Tandem ureteral stenting is a safe and feasible treatment for MUO, and had better efficacy compared to single ureteral stenting.

Key Points

• Ureteral stenting is an established treatment for the management of malignant ureteral obstruction (MUO)

• Prospective single-centre study showed that tandem ureteral stenting is a safe and feasible treatment for MUO

• Tandem ureteral stenting provides longer stent patency compared to single ureteral stenting in patient with MUO


Humans Hydronephrosis Prospective studies Stents Ureteral obstruction 



Malignant ureteral obstruction


Percutaneous nephrostomy



This study has received funding from the Taiwan Ministry of Science and Technology (MOST 105-2314-B-002-092).

Compliance with ethical standards


The scientific guarantor of this publication is Kao-Lang Liu.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from enrolled patients.

Ethical approval

Institutional Review Board approval was obtained.


• Prospective

• Prognostic study

• Performed at one institution


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Department of Medical ImagingNational Taiwan University Hospital and National Taiwan University College of MedicineTaipeiTaiwan
  2. 2.Department of Medical ImagingNational Taiwan University Hospital Yunlin BranchDouliu CityTaiwan
  3. 3.Department of UrologyNational Taiwan University Hospital and National Taiwan University College of MedicineTaipeiTaiwan

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