The aim of this study was to evaluate the effectiveness of ureteral
stent placement in diagnosing ureteropelvic junction (UPJ) obstruction in patients with negative or equivocal radiographic/nuclear studies and to assess relief of symptoms following definitive
surgical procedures to relieve the obstruction. Patients undergoing ureteral
stent placements performed by two attending urologists over an 18-month period were reviewed. All patients with equivocal or negative radiographic evaluations for
ureteral obstruction in whom the
stent was placed for diagnostic purposes were selected. Preoperative and postoperative information was obtained from the medical record or by telephone interview. Five patients were found who had equivocal radiographic studies along with symptoms of
flank pain and who underwent diagnostic
stent placement. All patients were female (average age 40 years, range 20-52). All had
pain relief following
stent placement and, on this basis, underwent an operative procedure to remove the presumed
ureteral obstruction. Three underwent Acucise endopyelotomy, one had laparoscopic resection of the right ovarian vein, and one underwent
nephrectomy. The average preoperative
creatinine level was 0.9 mg/dL (range 0.8-1.0), and the average postoperative
creatinine level was 1.0 mg/dL (range 0.9-1.1). All patients had relief of
flank pain at a mean of 17 months following the
surgical procedure. Relief of
pain following
stent placement in patients with clinical suspicion of
ureteral obstruction portends a favorable outcome from procedures to relieve the presumed obstruction. In unusual cases where
ureteral obstruction is suspected despite negative or equivocal radiographic findings, diagnostic
stent placement appears to be useful.