Impact of loop-tail ureteral stents on ureteral stent-related symptoms immediately after ureteroscopic lithotripsy: Comparison with pigtail ureteral stents

Ureteral stent encrustation is sometimes encountered, especially in cases in which a ureteral stent has been forgotten. An 84-year-old female patient with malignant myeloma underwent metallic ureteral stent insertion to treat malignant ureteral obstruction. At the time of scheduled ureteral stent exchange, the stent was heavily encrusted and could not be removed on either side. We performed endoscopic lithotripsy to remove the encrusted ureteral stents. The bilaterally encrusted metallic ureteral stents were successfully removed using Ho:YAG laser lithotripsy after inserting another ureteral stent placement besides the encrusted metallic ureteral stents.

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Multimodal management of forgotten encrusted ureteral stents

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v5i4.18607 ◽

2017 ◽

Vol 5 (4) ◽

pp. 116-119

Author(s):

Udaya Man Singh Dongol ◽

Roshan Ghimire

Keyword(s):

Urinary Bladder ◽

Percutaneous Nephrolithotomy ◽

Intravenous Urography ◽

Ureteral Stents ◽

Ureteroscopic Lithotripsy ◽

Medical College ◽

Stone Treatment ◽

Extracorporeal Lithotripsy ◽

Indwelling Time ◽

Multimodal Management

Background: Forgotten ureteral stents are seen in urologic practice because of ignorance of patients or failure of physician to counsel the patients. They can cause significant morbidity and pose a management and legal dilemma.Objectives: To evaluate the effi cacy and feasibility of different endourological approaches like percutaneous nephrolithotomy, ureteroscopic lithotripsy, cystolithotripsy and extracorporeal lithotripsy in the treatment of forgotten encrusted ureteral stents.Methods: Total 10 patients with forgotten encrusted double J stents from January 2013 to Nov 2015 were included. Mean age of the patients was 38.4 years (1.5 -5 years). All patients were evaluated for stent encrustation and associated stone burden by X-ray KUB and Intravenous Urography. Combined endourological procedures like percutaneous nephrolithotomy, ureteroscopic lithotripsy, cystolithotripsy and extracorporeal lithotripsy and even open surgery was done to remove these stents. The patients characteristics, indications for stenting, indwelling time, site of encrustation, hospital stay etc were all noted.Results: Total 10 patients presented with forgotten Double J stents. Out of three patients with large encrustations both in renal pelvis and urinary bladder, one patient underwent percutaneous nephrolithotomy and cystolithotripsy. Rest two patients underwent extracorporeal lithotripsy for two sessions for renal pelvic encrustation and cystolithotripsy for urinary bladder encrustation. Four patients underwent ureteroscopic and cystolithotripsy. Two patients in whom all fractured coils were in urinary bladder, underwent cystolithotripsy. All the stents were removed under C-arm fluoroscopic guidance. In one patient, open ureterotomy was done to remove the knotted stent.Conclusion: The use of Double J stent should be limited. The combination of various endourological techniques and extracorporeal lithotripsy can achieve effective stent and stone treatment with minimal morbidity and hospital stay.Journal of Kathmandu Medical College, Vol. 5, No. 4, Issue 18, Oct.-Dec., 2016, page: 116-119

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Effect of the Polaris Loop ureteral stent on vesicoureteral reflux and relief of lumbago symptoms: a single-center study

10.21203/rs.2.23262/v1 ◽

2020 ◽

Author(s):

Wei Yan ◽

Ludong Qiao ◽

Zhen Du ◽

Di Guan ◽

Hao Ping ◽

...

Keyword(s):

Vesicoureteral Reflux ◽

Ureteral Stent ◽

Patient Comfort ◽

Single Center ◽

Ureteroscopic Lithotripsy ◽

Single Center Study ◽

Vas Scores ◽

Left And Right ◽

Placement Technique ◽

Selection Of

Abstract Objective To verify the effect of the Polaris Loop ureteral stent on vesicoureteral reflux and relief of lumbago symptoms in patients after ureteroscopic procedures. Methods This was a prospective single-center analysis of 20 patients who received indwelling bilateral ureteral stents after undergoing ureteroscopic lithotripsy. The Polaris Loop stent and Polaris Ultra stent (both F6 and 26 cm) were implanted randomly on the left and right sides of a patient. The results of the visual analogue scale (VAS) of the symptoms of lumbar discomfort that occurred within 2 weeks after surgery and whether or not vesicoureteral reflux occurred during postoperative cystography were recorded. Results The differences between the VAS scores and rates of vesicoureteral reflux for the 2 types of stents were significant (p<0.05). The patients receiving the Polaris Loop stent had lower VAS scores and lower rates of vesicoureteral reflux than the patients receiving the Polaris Ultra stent. Conclusions The Polaris Loop stent led to improved patient comfort after ureteroscopy and prevented vesicoureteral reflux of urine. However, careful selection of the appropriate length of stent and appropriate placement technique is required.

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Surface analysis of ureteral stent before and after implantation in the bodies of child patients

Urolithiasis ◽

10.1007/s00240-020-01211-9 ◽

2020 ◽

Author(s):

Katarzyna Arkusz ◽

Kamila Pasik ◽

Andrzej Halinski ◽

Adam Halinski

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Urinary Bladder ◽

Tract Infection ◽

Ureteral Stent ◽

Ureteral Stents ◽

Salt Deposition ◽

Child Patients ◽

Before And After ◽

Dj Stent

Abstract The aim of this work was to determine which part of a double-J ureteral stent (DJ stents) showed the highest tendency to crystal, calculi, and biofilm deposition after ureterorenoscopic-lithotripsy procedure (URS-L) to treat calcium oxalate stones. Additionally, the mechanical strength and the stiffness of DJ stents were evaluated before and after exposure to urine. Obtained results indicated that the proximal (renal pelvis) and distal (urinary bladder) part is the most susceptible for post-URS-L fragments and urea salt deposition. Both, the outer and inner surfaces of the DJ ureteral stents were completely covered even after 7 days of implantation. Encrustation of DJ stents during a 31-day period results in reducing the Young’s modulus by 27–30%, which confirms the loss of DJ stent elasticity and increased probability of cracks or interruption. Performed analysis pointed to the need to use an antibacterial coating in the above-mentioned part of the ureteral stent to prolong its usage time and to prevent urinary tract infection.

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Encrusted Ureteral Stent Retrieval Using Flexible Ureteroscopy with a Ho: YAG Laser

Case Reports in Medicine ◽

10.1155/2012/862539 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 6

Author(s):

Takashi Kawahara ◽

Hiroki Ito ◽

Hideyuki Terao ◽

Takehiko Ogawa ◽

Hiroji Uemura ◽

...

Keyword(s):

Yttrium Aluminum Garnet ◽

Renal Stones ◽

Ureteral Stent ◽

Flexible Ureteroscopy ◽

Ureteral Stents ◽

Yag Laser ◽

Stent Retrieval ◽

Yttrium Aluminum

A 23-year-old female had bilateral ureteral stents placed due to bilateral renal stones and hydronephrosis. The bilateral ureteral stents were changed every 3 months. A kidney ureter bladder (KUB) film showed left encrustation along the ureteral stent thus necessitating removal; however, the ureteral stent could not be removed cystoscopically. The ureteral stent was, therefore, extracted using flexible ureteroscopy (URS) with a holmium (Ho): yttrium aluminum garnet (YAG) laser.

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Outcomes of Ureteral Stent Placement for Hydronephrosis in Patients with Gynecological Malignancies

Current Urology ◽

10.1159/000447165 ◽

2016 ◽

Vol 10 (3) ◽

pp. 126-131 ◽

Cited By ~ 2

Author(s):

Saya Kurata ◽

Shohei Tobu ◽

Kazuma Udo ◽

Mitsuru Noguchi

Keyword(s):

Radiation Therapy ◽

Stent Placement ◽

Poor Prognosis ◽

Ureteral Stent ◽

Ureteral Stents ◽

Ureteral Stenosis ◽

Stent Removal ◽

Gynecological Malignancies ◽

Lymph Node Swelling ◽

Observation Period

Objective: We examined the outcomes of patients undergoing ureteral stent placement for hydronephrosis that occurred during treatment for gynecological malignancies. Materials and Methods: From January 2004 to December 2009, we enrolled 33 patients with 45 ureters undergoing ureteral stent placement for hydronephrosis which occurred during treatment for gynecological malignancies. We examined the outcomes of the patients after stent placement. Results: The causes of hydronephrosis were obstruction of the urinary tract by a tumor (n = 22), obstruction due to lymph node swelling (n = 6), ureteral stenosis after radiation therapy (n = 4), and others (n = 1). The ureteral stent was inserted into both ureters in 12 cases, and into one ureter in 21 cases. Ureteral stents were replaced 1-26 times during the observation period (median 3 times). Eighteen (40%) ureteral stents were removed. The reasons for ureteral stent removal were hydronephrosis improvement (11 ureters, 24.4%), a change to nephrostomy (cystectomy: 1 ureter, progression of ureteral stenosis: 2 ureters), renal atrophy (3 ureters), and ureteral dilatation (1 ureter). All of the cases in which ureteral stent withdrawal due to hydronephrosis improvement were cases in which the ureter was compressed by a tumor and were lower ureteral obstructions. Twenty-one patients (64%) died due to cancer after stent placement. The periods from the first stent placement to death ranged from 1 to 58 months (median 18 months). Conclusion: Ureteral stent placement was associated with a poor prognosis in patients with gynecological malignancies. There were a few cases in which stent withdrawal became possible due to the improvement of hydronephrosis. In such cases, the withdrawal rate varied according to the cause and obstructive level.

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Optimal timing of ureteroscopic lithotripsy after the initial drainage treatment and risk factors for postoperative febrile urinary tract infection in patients with obstructive pyelonephritis: a retrospective study

10.21203/rs.3.rs-46783/v3 ◽

2020 ◽

Author(s):

Yoshitaka Itami ◽

Makito Miyake ◽

Takuya Owari ◽

Takashi Iwamoto ◽

Daisuke Gotoh ◽

...

Keyword(s):

Risk Factors ◽

Urinary Tract Infection ◽

Stent Placement ◽

Operation Time ◽

Ureteral Stent ◽

Optimal Timing ◽

Febrile Urinary Tract Infection ◽

Ureteroscopic Lithotripsy ◽

History Of ◽

Obstructive Pyelonephritis

Abstract Background: A history of preoperative obstructive pyelonephritis has been reported as a risk factor for febrile urinary tract infection (fUTI) after ureteroscopic lithotripsy (URSL). But there is no clear evidence of risk factors for developing fUTI including the optimal timing of URSL after obstructive pyelonephritis treatment.Methods: Of the 1361 patients, who underwent URSL at our hospital from January 2011 to December 2017, 239 patients had a history of pre-URSL obstructive pyelonephritis. The risk factors were analyzed by comparing the patients’ backgrounds with the presence or absence of fUTI after URSL. The factors examined were age, gender, body mass index, comorbidity, presence or absence of preoperative ureteral stent, stone position, stone laterality, stone size, Hounsfield unit (HU) value on computed tomography scan, history of sepsis during obstructive pyelonephritis, period from antipyresis to URSL, ureteral stenting period, operation time, and presence or absence of access sheath at URSL. In addition, the stone components and renal pelvic urinary culture bacterial species during pre-URSL pyelonephritis were also examined.Results: Post-URSL fUTI developed in 32 of 239 patients (13.4%), and 11 of these 32 cases led to sepsis (34.4%). Univariate analysis showed that stone position, stone maximum HU value, presence of sepsis during obstructive pyelonephritis, period from antipyresis to URSL, pre-URSL ureteral stent placement, operation time were risk factors of fUTI. Stone components and urinary cultures during pyelonephritis were not associated with risk of fUTI. Multivariate analysis showed that renal stone position, pre-URSL ureteral stent placement > 21 days, and operation time > 75 minutes were independent risk factors of fUTI following the URSL.Conclusions: F-UTI following the URSL could be avoided by ureteral stent placement period 21 days or less and operation time 75 minutes or less in patients with obstructive pyelonephritis.

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Novel method to decrease the exposure time of the extraction string of the ureteral stent and its efficiency and safety verification in the clinic

Scientific Reports ◽

10.1038/s41598-021-01821-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

WenGang Hu ◽

YaJun Song ◽

Yang Li ◽

YueHua Li ◽

Jiao Mu ◽

...

Keyword(s):

Exposure Time ◽

Medical Costs ◽

Demographic Characteristics ◽

Ureteral Stent ◽

Continuous Exposure ◽

The Novel ◽

Ureteral Stents ◽

Stent Removal ◽

Significant Difference ◽

Novel Method

AbstractUreteral stent removal by an extraction string is advantageous. However, the increased risk of complications attributed to the continuous exposure of the string outside the urethra must be managed. This paper introduces a method to decrease the exposure time, and conducts a retrospective study to verify its efficiency and safety. A total of 231 male patients undergoing routine ureteroscopy (URS) were included, and all of them accepted indwelling ureteral stents with strings. Among them, 123 patients (Normal-S group) underwent the normal method to determine the length of string (Lstring), which was shortened to 4 cm (cm) past the urethral meatus; 108 patients (Novel-S group) underwent the novel method (Lstring = Lurethra + 2 cm), the length of urethra (Lurethra) was measured during ureteroscopy by ureteroscope body. The demographic characteristics, stent indwelling and removal-related variables, complications, and medical costs in each group were recorded. There was no significant difference in demographic characteristics, the rate of UTI, the operative duration of URS, or the VAS pain scores for stent removal between the 2 groups. For the Novel-S group, the stent dwelling time was longer, the self-rated discomfort and symptom, the stent dislodgement rate, the numbers of clinic or emergency visits and the overall medical cost post operation was lower in comparison with the Normal-S group, while the rate of removal of stents by hand was lower, the time for removing ureteral stents was longer. This novel method improved stenting comfort, avoided ureteral stent dislodgement, decreased complications, and lowered medical costs, it was safe and reliable and merits widespread application.

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Optimal timing of ureteroscopic lithotripsy after the initial drainage treatment and risk factors for postoperative febrile urinary tract infection in patients with obstructive pyelonephritis: a retrospective study

10.21203/rs.3.rs-46783/v2 ◽

2020 ◽

Author(s):

Yoshitaka Itami ◽

Makito Miyake ◽

Takuya Owari ◽

Takashi Iwamoto ◽

Daisuke Gotoh ◽

...

Keyword(s):

Risk Factors ◽

Urinary Tract Infection ◽

Stent Placement ◽

Operation Time ◽

Ureteral Stent ◽

Optimal Timing ◽

Febrile Urinary Tract Infection ◽

Ureteroscopic Lithotripsy ◽

History Of ◽

Obstructive Pyelonephritis

Abstract Background: A history of preoperative obstructive pyelonephritis has been reported as a risk factor for febrile urinary tract infection (fUTI) after ureteroscopic lithotripsy (URSL). But there is no clear evidence of risk factors for developing fUTI including the optimal timing of URSL after obstructive pyelonephritis treatment. Methods: Of the 1361 patients, who underwent URSL at our hospital from January 2011 to December 2017, 239 patients had a history of pre-URSL obstructive pyelonephritis. The risk factors were analyzed by comparing the patients’ backgrounds with the presence or absence of fUTI after URSL. The factors examined were age, gender, body mass index, comorbidity, presence or absence of preoperative ureteral stent, stone position, stone laterality, stone size, Hounsfield unit (HU) value on computed tomography scan, history of sepsis during obstructive pyelonephritis, period from antipyresis to URSL, ureteral stenting period, operation time, and presence or absence of access sheath at URSL. In addition, the stone components and renal pelvic urinary culture bacterial species during pre-URSL pyelonephritis were also examined. Results: Post-URSL fUTI developed in 32 of 239 patients (13.4%), and 11 of these 32 cases led to sepsis (34.4%). Univariate analysis showed that stone position, stone maximum HU value, presence of sepsis during obstructive pyelonephritis, period from antipyresis to URSL, pre-URSL ureteral stent placement, operation time were risk factors of fUTI. Stone components and urinary cultures during pyelonephritis were not associated with risk of fUTI. Multivariate analysis showed that renal stone position, pre-URSL ureteral stent placement > 21 days, and operation time > 75 minutes were independent risk factors of fUTI following the URSL. Conclusions: F-UTI following the URSL could be avoided by ureteral stent placement period 21 days or less and operation time 75 minutes or less in patients with obstructive pyelonephritis.

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