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Memokath 051 Ureter stent for ureteric obstruction (update of MTG35)

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1 Recommendations

1.1 Memokath 051 Ureter stent is recommended as an option to manage ureteric obstruction in adults with:

  • malignant ureteric obstruction and anticipated medium or long-term survival after adjunctive therapy

  • benign ureteric obstruction who cannot have or do not want reconstructive surgery

  • any type of ureteric obstruction who cannot have or do not want a double‑J stent, or when repeat procedures are particularly high risk.

1.2 Data should be collected prospectively on ureteric stent procedures, including details of patient selection, choice of stent placement procedure and stent used, and adverse events such as stent migration and encrustation rates.

Why the committee made these recommendations

NICE originally recommended Memokath 051 for ureteric obstruction in selected people.

New clinical evidence from retrospective studies suggests that Memokath 051 relieves ureteric obstruction as well as other stents.

For people with malignant ureteric obstruction, Memokath 051 may have advantages over some other treatments because it is a less invasive procedure than nephrostomy with no need for hospital stay, and fewer stent replacements needed compared with other stents.

Clinical experts also felt that it was important to have Memokath 051 as an option for other people, for example people who cannot have or do not want reconstructive surgery or a double-J stent, or when repeat procedures are particularly high risk.

The cost modelling suggests Memokath 051 is likely to be cost saving compared with other stents. This is because it may not need to be replaced as often as other stents. But the cost savings are not certain because there's not enough good quality evidence.

There is enough evidence to continue recommending Memokath 051 for selected adults with ureteric obstruction. But prospective data is still needed to be certain about the cost savings of using it, compared with other stents.