Do you use a larger or smaller diameter ureteral stent in a patient with hydronephrosis due to malignant obstruction?

Malignant ureteral obstruction is the most difficult to manage. Two approaches:

• balloon-dilate the area of the stricture to 15 Fr with a 5 mm appropriately long ureteral dilating balloon, and then
• either put up two 6 Fr indwelling stents OR consider placing a Resonance stent (Cook Urology).