One-port, single-incision laparoscopy is part of the natural development of minimally invasive surgery. Refinement and modification of laparoscopic instrumentation has resulted in a substantial increase in the use of laparoendoscopic single-site surgery (LESS) in urology over the past 2 years. Since the initial report of single-port nephrectomy in 2007, urologists have successfully performed various procedures with LESS, including partial nephrectomy, pyeloplasty, orchiectomy, orchiopexy, ureterolithotomy, sacrocolpopexy, renal biopsy, renal cryotherapy, and adrenalectomy. Further advancements in technology, such as magnetic anchoring and guidance systems, and robotic instrumentation, may allow broader application of this emerging surgical technique. Future research is required to determine the intraoperative and postoperative benefits of LESS in comparison with standard laparoscopy.
IMPORTANCE Surgical site infections increase patient morbidity and health care costs. The Centers for Disease Control and Prevention emphasize improved basic preventive measures to reduce bacterial transmission and infections among patients undergoing surgery. OBJECTIVE To assess whether improved basic preventive measures can reduce perioperative Staphylococcus aureus transmission and surgical site infections.
Objective
To determine whether ureteric stent extraction strings affect stent‐related quality of life (QoL) or increase complications after ureteroscopy (URS) for stone disease.
Patients and Methods
In all, 68 patients undergoing URS (October 2011 to May 2013) for stone disease were randomised to receive a ureteric stent with or without an extraction string.
Patients completed the Ureteric Stent Symptom Questionnaire (USSQ) on postoperative days 1 and 6, and 6 weeks after stent removal.
Pain was assessed at stent removal.
Adverse events, including early stent removal, stent migration, retained stent, urinary tract infection (UTI), emergency room (ER) visits and postoperative phone calls were monitored.
Results
There was no difference in stent‐related QoL as measured by the USSQ between those with and without a stent extraction string, pain at stent removal between those who pulled their stent independently vs those who underwent cystoscopy for stent removal, or in the rate of UTIs, ER visits or phone calls between groups.
Five patients (four female, one male) removed their stent early by inadvertently pulling the string; none required replacement.
Patients without a string had a significantly longer period with the postoperative ureteric stent (10.6 vs 6.3 days, P < 0.001).
One patient without a stent string retained her ureteric stent for 6 months, which was removed by cystoscopy without incident.
Conclusion
Ureteric stent extraction strings may offer several advantages without increasing stent‐related urinary symptoms, complications, or postoperative morbidity.
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