Introduction: To assess long-term outcomes of double internal stents (DIS) for the relief of external malignant ureteral obstruction (MUO). Materials and Methods: DIS (7 FR each; 12-month indwelling time) were inserted under general anesthesia in 62 consecutive patients (75 renal units) with MUO during 2007-2018. Surveillance was performed every 3 months, and stents were exchanged routinely every year. The need for permanent stent retrieval was considered stent failure. Maintenance of stent patency and disease-specific survival (DSS) were estimated (Kaplan-Meier). Risk factors were also assessed (univariate and multivariable Cox regression analyses). Results: The median follow-up was 27 months (IQR 20-27). The most frequent tumors causing obstruction were colorectal and ovarian cancers. Six patients (10%) had stent failure due to sepsis, creatinine elevation or hematuria. The average time to failure was 15 months (range 1-27). A history of radiation and an estimated glomerular filtration rate (eGFR) ≤45 ml/min/1.73 m2 were associated with stent failure (p=0.038 and p=0.001, respectively). Thirty-nine patients died with a median DSS of 21 months (IQR 8.6-not reached). Multivariate analysis identified eGFR ≤60 ml/min/1.73 m2 (HR 2.1, [95%CI 1.1-4.2], p=0.02) and need for balloon dilation (HR 2.1, [95%CI 1.1-4.1], p=0.02) as independent predictors for disease-related mortality. Twenty-six patients (42%) had stent-related complications, e.g., irritative symptoms, hematuria and infections, of whom only 2 failed. Conclusions: One-year indwelling DIS provide effective long-term relief of MUO and represent a simple and effective alternative to other methods of urinary diversion. They avoid the need for external tubes and contribute to improved patient satisfaction.

Background:Finegoldia magna (F. magna) is a rare pathogen causing infective endocarditis (IE). Only 7 cases are documented in the literature. Case Report:We report a case of infective endocarditis in a 45-year-old male due to F. magna 2 months after ...