Minimally painful retrieval of ureteral stents using by ureterescope

Abstract

Aim: The standard method for retrieving the ureteral stents is the cystoscopic technique. We describe a minimally painful method for retrieving ureteral stents by using an ureteroscope. Methods: A total of 60 patients with ureteral stents were enrolled in this study. The patients were randomized into a cystoscopic (30 cases) and an ureteroscopic (30 cases) group. All stents were retrieved by a cystoscope in the first group and by an ureteroscope in the second group, under topical anesthesia. Patients in each group were assessed for stented time, stent side and reason of stent placement, operative time, peroperative pain, postoperative pain, irritative voiding symptoms and hematuria. Results: Stents were successfully retrieved in 60 patients. There were no statistical differences in the two groups regarding patient\'s gender and age or stent side, operative time and stented time (p>0.05). Mean operative pain score was significantly higher in the cystoscopic group than in the ureteroscopic group (p

Keywords

• Ureteroscopy, stents, cystoscopy, pain.

Üreteral stentin üreteroskop kullanılarak minimal ağrıyla çıkarılması

Öz

Amaç: Üreteral stentlerin geriye çekiminde sistoskopik teknik standart yöntemdir. Biz bu çalışmada, üreteroskop kullanarak minimal ağrılı üreteral stent çekimi yöntemini araştırdık. Yöntemler: Üreteral stenti bulunan 60 hasta çalışmaya alındı. 30 hasta sistoskopik gurup, 30 hasta üreteroskopik grup olacak şekilde hastalar rastgele iki gruba ayrıldı. Bütün stentler lokal anestezi altında, birinci grupta sistoskop kullanılarak, ikinci grupta ise üreteroskop kullanılarak çekildi. Hastalar stentli kalma zamanları, stentin bulunduğu taraf, stent takılma nedeni, operasyon süresi, operasyon sırasındaki ağrı, operasyon sonrası ağrı, irritatif işeme semptomları ve hematüri yönünden değerlendirilerek sonuçlar kaydedildi. Bulgular: Stentler 60 hastada da başarıyla çekildi. Cinsiyet, hasta yaşı, stent tarafı, operasyon süresi, stentin kalış süresi açısından her iki grup arasında istatistiksel olarak anlamlı bir fark yoktu (p>0.05). Ortalama operasyon sırasındaki ağrı sistoskopik grupta anlamlı şekilde diğer gruptan yüksek olarak tespit edildi (p

Anahtar Kelimeler

• Üreteroskopi, stent, sistoskopi, ağrı

Kaynakça

1. Reid G DJ, Tieszer C. Encrustation and microbial adhesion on stents. In: Stenting the Urinary System. Edited by D. Yachia. Oxford: Isis Medical Media, 1998, chapt. 10, pp. 79–83.
2. Yap RL, Batler RA, Kube D, Smith ND. Retrieval of migrated ureteral stent by intususception of ureteral balloon dilator tip. Urology 2004;63:571-573.
3. Isen K. Retrieval of DJ stent by using ureteroscope in an in- fant. J Pediatr Urol 2008;4:247-8.
4. Jeong H, Kwak C, Lee SE. Ureteric stenting after ureteroscopy for ureteric stones: a prospective randomized study assess- ing symptoms and complications. BJU Int 2004;93:1032-4
5. Taylor WN, McDougall IT. Minimally invasive ureteral stent retrieval. J Urol 2002;168:2020-3.
6. Figueroa TE. Retrieval of ureteral stents in children. Tech Urol 1995;1:45-7.
7. Schulman CC WT, Zlotta AR: Single-J ureteral stent with a distal suture. In: Stenting the Urinary System. Edited by D. Yachia. Oxford: Isis Medical Media, 1998, chapt. 20, pp. 161-4.
8. Wetton CW, Gedroyc WM. Retrograde radiological retrieval and replacement of double-J ureteric stents. Clin Radiol 1995;50:562-5.

9. Vesey SG, Athmanathan N. A computerized ureteric stent re- trieval system. Br J Urol 1996;78:156-7.
10. Cowan NC, Cranston DW. Retrograde radiological retrieval and replacement of double-J ureteric stents. Clin Radiol 1996;51:305-6.
11. Evans JW, Ralph DJ. Removal of ureteric stents with a flex- ible cystoscope. Br J Urol 1991;67:109-11.
12. Fowler CG. Removal of ureteric stents with the flexible cys- toscope. Br J Urol 1987;60:280-3.
13. Iyer SK, Alston D. New flexible cystoscopic stent retriever forceps. Br J Urol 1991;68:441-4.
14. Simonato A, Galli S, Carmignani G. Simple, safe and inex- pensive retrieval of JJ stents with a flexible cystoscope. Br J Urol 1998;81:490-1.
15. Yoshimura R, Wada S, Kishimoto T. Why the flexible cysto- scope has not yet been widely introduced?: A questionnaire to Japanese urologists. Int J Urol 1999;6:549-59.
16. Dyer RB, Chen MY, Zagoria RJ, Regan JD, Hood CG, Ka- vanagh PV. Complications of ureteral stent placement. Ra- diographics 2002;22:1005-22.