scholarly journals A survey of Canadian renal transplant surgeons: Use of ureteric stents and technique of the ureteroneocystotomy

2018 ◽  
Vol 12 (12) ◽  
Author(s):  
Luke F. Reynolds ◽  
Tad Kroczak ◽  
R. John Honey ◽  
Kenneth T. Pace ◽  
Jason Y. Lee ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Dwell Time ◽  
Online Survey ◽  
Primary Outcome ◽  
Prophylactic Antibiotics ◽  
Ureteric Stent ◽  
Stent Removal ◽  
Ureteric Stenting ◽  
Ureteric Stents

Introduction: The role of ureteric stenting in renal transplant has been well-demonstrated. The goal of this survey was to determine the use of ureteric stents by Canadian transplant surgeons and how the ureteroneocystotomy and followup is performed. Methods: An online survey was sent to the 40 surgeon members of the Canadian Society of Transplantation. The primary outcome was the rate of ureteric stent use at the time of renal transplantation. The secondary outcomes were the ureteric stent dwell time, use and type of prophylactic antibiotics, and the use of routine post-transplant ultrasonography. Results: All respondents (25) used ureteric stent routinely and 92% remove the stent between four and six weeks postoperatively. Prophylactic antibiotics were used 64% of the time for ureteric stent removal. The majority of surgeons do not routinely perform a post-stent removal ultrasound. Fifty-six percent of respondents perform a refluxing anastomosis. Conclusions: Ureteric stents are routinely used in renal transplant in Canada. Areas for improvement and topics of debate identified from this survey are the need for peri-stent removal antibiotics, the role of post-stent removal ultrasound, the duration of stent dwell time, and the need for a non-refluxing ureteroneocystotomy.

scholarly journals Cost Analysis and Service Delivery on Using Isiris α™ To Remove Ureteric Stents

2018 ◽  
Vol 1 (1) ◽  
pp. e3-e16 ◽  
Author(s):  
Yih Chyn Phan ◽  
Jonathan Cobley ◽  
Wasim Mahmalji
Keyword(s):  
Medical Association ◽  
Cost Analysis ◽  
Ureteric Stent ◽  
Flexible Cystoscopy ◽  
Stent Removal ◽  
Ureteric Stents ◽  
Flexible Cystoscope ◽  
Single Use ◽  
College Of Nursing ◽  
The Cost

Introduction Isiris α™ (Coloplast®) is an innovative single-use disposable flexible cystoscope with an integrated ureteric stent grasper designed specifically to remove ureteric stents. It allows clinicians to remove ureteric stents easily on the wards or in clinics without the need of arranging a routine and dedicated flexible cystoscopy appointment for patients. We evaluated Isiris α’s practical use and cost analysis against traditional reusable endoscopes. Method We compared the cost of removing ureteric stents using Isiris α™ in 10 patients prospectively versus traditional flexible cystoscopes in 10 patients retrospectively. The costs of the equipment, medications, reprocess machines, and utility costs were consulted from the relevant departments and companies. As for labour cost, we have sourced British Medical Association (BMA) and Royal College of Nursing (RCN) websites. Results From our study, it costs £260.65 and £123.41 on average to remove a ureteric stent using Isiris α™ and traditional flexible cystoscope respectively (p<0.001). Stent removal in the endoscopy department was delayed in 60% of patients, on average 6.4 days, compared to 0% of patients using Isiris α™ (p = 0.048). Conclusion Although Isiris α™ is shown to be a more expensive option to remove ureteric stents based on our analysis, it still provides clinicians flexibility and ease in removing ureteric stents in the outpatient clinic, reducing the pressure and demand for dedicated flexible cystoscopy slots in the endoscopy department.

Safety and Potential Benefits of Early Ureteric Stent Removal Tied With Urinary Catheter After Renal Transplant.

2014 ◽  
Vol 98 ◽  
pp. 638-639 ◽  
Author(s):  
S. Soldano ◽  
A. Ali ◽  
K. Pawelec ◽  
C. Sammartino ◽  
R. Sivaprakasam ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Urinary Catheter ◽  
Ureteric Stent ◽  
Stent Removal ◽  
Potential Benefits

Isiris™ for Ureteric Stent Removal in Renal Transplantation: An Initial Single-Centre Experience of 150 Cases

2021 ◽  
pp. 155335062110072
Author(s):  
Daniel T. Doherty ◽  
Zia Moinuddin ◽  
Ben R. Grey ◽  
David van Dellen
Keyword(s):  
Outpatient Clinic ◽  
Healthcare Providers ◽  
Operating Theatre ◽  
Stent Insertion ◽  
Environmental Implications ◽  
Ureteric Stent ◽  
Stent Removal ◽  
Ureteric Stents ◽  
Urological Complications ◽  
Single Use

Background. Ureteric stent insertion is performed at the time of renal transplant to minimise the risk of post-operative urological complications, including anastomotic leak and ureteric stenosis or obstruction. Transplant ureteric stent removal (TUSR) has historically been performed via flexible cystoscopy, predominantly in a theatre setting. Isiris™ is a single-use cystoscope with integrated grasper designed for removal of ureteric stents. We report our initial experience. Methods. A retrospective analysis of a contemporaneously maintained database was performed with review of case notes from October 2017 to September 2018. TUSR was performed by surgical middle grades with a single nurse assistant. Results. One hundred and fifty ureteric stents were removed in transplant recipients (mean age 50.2 years, SD ± 15.2; 61.3% male). 91.3% ( n = 137) of cases were performed in the outpatient clinic. Median time to TUSR was 42 days (IQR 30-42). 147 attempts at removal were successful. One urinary tract infection (UTI) was reported following TUSR. Use of the Isiris™ for TUSR corresponds to a £63,480 saving in this cohort compared to conventional practice. This value is conservative and does not include income that has been gained from the reallocation of operating theatre capacity. Conclusion. Isiris™ can safely be employed for the timely performance of non-complicated TUSR. Isiris™ releases this procedure from the confines of the operating theatre to the outpatient clinic. This reduces the resource burden for healthcare providers and may result in improved patient satisfaction. The environmental implications of disposable healthcare equipment require consideration. Evaluation of Isiris™ TUSR for encrustation is required.

scholarly journals The Efficacy and Safety of Ureteric Stent Removal with Strings versus No Strings: Which Is Better?

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Zhenkai Luo ◽  
Binbin Jiao ◽  
Hang Zhao ◽  
Tao Huang ◽  
Lin Geng ◽  
...  
Keyword(s):  
Dwell Time ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Program Review ◽  
Current Evidence ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Ureteric Stent ◽  
Stent Removal ◽  
The Cochrane Library

Objective. To evaluate the current evidence on the effectiveness and safety of ureteric stent removal using strings compared to conventional methods. Materials and Methods. The electronic databases PubMed, Embase, China National Knowledge Infrastructure (CNKI), and the Cochrane Library were systematically searched up to March 2020. Two reviewers searched the literature, independently extracted the data, and evaluated the quality of the studies according to the inclusion and exclusion criteria. The data analysis was performed with the software program Review Manager 5.3. Results. Eleven studies with a total of 1809 patients were included in the analysis based on the inclusion criteria. Our meta-analysis showed that visual analogue scale (VAS) scores were significantly lower in the string group than in the conventional group (weighted mean difference (WMD) -2.63; 95% confidence interval (CI) -3.68, -1.58; P < 0.00001 ). In terms of stent dwell time, the string group had an advantage (WMD -9.53; 95% CI -14.20, -4.86; P < 0.0001 ). In addition, no significant differences in the occurrence of urinary tract infection (UTI) (odds ratio (OR) 1.03; 95% CI 0.62, 1.72; P = 0.92 ), emergency room visits (OR 0.99; 95% CI 0.59, 1.67; P = 0.97 ), or other complications ( P > 0.05 ) were observed between the two groups. Conclusion. Our findings suggest that an extraction string is an effective and safe method for the removal of ureteric stents. This method gives patients the benefits of reduced pain and shortened stent dwell time without increasing the risk of UTI. Nevertheless, these findings should be further confirmed through large-volume, well-designed prospective randomized controlled trials (RCTs).

scholarly journals Ureteric Stent Card Register – A 5-Year Retrospective Analysis

2008 ◽  
Vol 90 (2) ◽  
pp. 156-159 ◽  
Author(s):  
Vincent CY Tang ◽  
John Gillooly ◽  
Elaine WY Lee ◽  
Clive R Charig
Keyword(s):  
Retrospective Analysis ◽  
Retrospective Review ◽  
Tracking System ◽  
Stone Disease ◽  
Local Hospital ◽  
Common Indication ◽  
Ureteric Stent ◽  
Stent Removal ◽  
Ureteric Stenting

INTRODUCTION Ureteric stenting is a common urological procedure. Forgotten stents have a well-documented morbidity and mortality. Therefore, we asked the question, is a stent register an important factor in reducing the number of lost or overdue stents? PATIENTS AND METHODS We conducted a retrospective review of 203 patients who had ureteric stents inserted in the operating theatre, for the 5-year period 1 December 1998 to 1 December 2003. We analysed all stent cards, patient notes and theatre logs; where no record of stent removal was found, we contacted the patient, their GP or their local hospital. RESULTS A total of 191 patients were identified from the stent card register. An additional 12 patients were found from the theatre logs, but with no record in the stent card register. Of the 203 patients, 8 had bilateral stents. The most common indication for stenting was stone disease. Of the 203 patients, 11 had overdue stents and 51 had no record of the stents ever being removed. The 51 presumed ‘forgotten’ stents were traced, and it was found that 42 patients had had their stents removed by other hospitals, and 9 patients died with stents in situ, but before they were due for removal. CONCLUSIONS Our current stent card tracking system is ineffective, because it was infrequently reviewed. However, despite overdue and ‘forgotten’ stents which were removed by other hospitals, no patients came to any real harm and we had no lost stents. Our stent register system did not appear to play any role in terms of preventing stent loss, and it seems likely that there are other more effective safeguards in place to prevent this from happening. However, if a stent register was required at all, a computerised system would be preferable. Alternatively, patients could share some of the responsibility of stent tracking with their clinicians.

Testing the Strain Theory of Suicide – The Moderating Role of Social Support

Crisis ◽  
2020 ◽  
Vol 41 (2) ◽  
pp. 82-88 ◽  
Author(s):  
Bob Lew ◽  
Ksenia Chistopolskaya ◽  
Yanzheng Liu ◽  
Mansor Abu Talib ◽  
Olga Mitina ◽  
...  
Keyword(s):  
Social Support ◽  
Suicidal Behavior ◽  
Online Survey ◽  
Perceived Social Support ◽  
Strain Theory ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Psychological Strains ◽  
Moderating Role

Abstract. Background: According to the strain theory of suicide, strains, resulting from conflicting and competing pressures in an individual's life, are hypothesized to precede suicide. But social support is an important factor that can mitigate strains and lessen their input in suicidal behavior. Aims: This study was designed to assess the moderating role of social support in the relation between strain and suicidality. Methods: A sample of 1,051 employees were recruited in Beijing, the capital of China, through an online survey. Moderation analysis was performed using SPSS PROCESS Macro. Social support was measured with the Multidimensional Scale of Perceived Social Support, and strains were assessed with the Psychological Strains Scale. Results: Psychological strains are a good predictor of suicidality, and social support, a basic need for each human being, moderates and decreases the effects of psychological strains on suicidality. Limitations: The cross-sectional survey limited the extent to which conclusions about causal relationships can be drawn. Furthermore, the results may not be generalized to the whole of China because of its diversity. Conclusion: Social support has a tendency to mitigate the effects of psychological strains on suicidality.

Selecting which touchpoints to manage for customer loyalty: an empirical analysis in retail banking

2019 ◽  
pp. 39-54
Author(s):  
Marco Ieva ◽  
Cristina Ziliani
Keyword(s):  
Empirical Analysis ◽  
Customer Loyalty ◽  
Online Survey ◽  
Customer Experience ◽  
Retail Banking ◽  
Customer Experience Management ◽  
Moderating Role

Customer Experience develops through a journey of touchpoints. However, little is known on the role of touchpoints in contributing to customer loyalty, which is the final aim of Customer Experience Management. This study provides an examination of the relative and moderating role of frequency and positivity of exposure to more than twenty touchpoints and their interplay in contributing to customer loyalty. An online survey on more than three thousand consumers is run with reference to retail banking. Results show that only a small number of touchpoints is significantly related to customer loyalty. Findings point companies' attention to invest their efforts in managing both the frequency and positivity of specific touchpoints.

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