Retrovesical migration of malpositioned double-j ureteral stent

Ioannis, Chrysogonidis; Zoumpos, Ioannis; Ioannidis, Evangelos; Konstantinos, Giannakogiorgos

doi:10.1023/b:urol.0000022913.96740.e8

Cited by 12 publications

(5 citation statements)

References 3 publications

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“…Ureteral stent insertion is traditionally performed using a cystoscope guided by a fluoroscope. However, the fluoroscope is not always available[12] and so the procedure is often performed blindly. Due to the extensive use of DJ stents in urology, many complications have been reported.…”

Section: Discussionmentioning

confidence: 99%

Fluoroscopy-free double-J stent placement through ureteroscope working channel postuncomplicated ureteroscopic laser lithotripsy: A novel technique

et al. 2019

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Objectives:To report a technique for ureteroscopic laser lithotripsy (URSL) and retrograde placement of a double-J (DJ) stenting through the ureteroscope working channel without the use of a fluoroscope compared to the conventional technique.Patients and Methods:Between June 2015 and December 2017, 170 patients selected for URSL for treatment of ureteral stones and DJ insertion was evaluated. Patients are divided into two groups according to the use of fluoroscopy. In Group A (100 patients), fluoroscope is used and group B (70 patients) without fluoroscopy guidance. In group B, URSL is performed first and followed by DJ insertion by the semi-rigid ureteroscope 8.5-11 Fr under vision without fluoroscopy.Results:Stone free rate in 96% versus 94.3% for groups A and B respectively. This technique was successful in all the included patients: 166 retrograde DJ stenting post URSL for ureteric calculi and 4 cases for anuria. Group A are exposed to radiation with mean 26.6 seconds in URSL procedure and 4.8 seconds for DJ stenting. Group B was exposed to zero dose. For group A, the stents size was 6 Fr for 70% of patients and 15 % for 4.7 Fr and 15% for 7 Fr stenting. In Group B, stents of 4.7 Fr and length 24-26 cm were used in all patients. Failure of DJ insertion is reported in 9% for group A and 13 (18.5%) patients for group B.Conclusions:This study report the feasibility and efficacy of the completely fluoroscopy free URSL and DJ stenting to treat ureteric stones.

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Section: Discussionmentioning

confidence: 99%

Fluoroscopy-free double-J stent placement through ureteroscope working channel postuncomplicated ureteroscopic laser lithotripsy: A novel technique

et al. 2019

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“…If possible, this process should be performed under fluoroscopy. However, fluoroscopy is not universally available in endoscopy rooms (8), and so the procedure is often performed blind.…”

Section: Discussionmentioning

confidence: 99%

Double-J stent placement with grasping forceps through ureteroscope working channel: a novel technique

Koç¹,

Bayrak²

2013

Turk J Med Sci

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Th e accurate estimation of tree biomass is crucial for the effi cient management of forest resources. In this study, we used a subsampling method for unbiased estimates of above-ground tree biomass. Th e method consists of 2 stages: the fi rst stage consists of randomized branch sampling (RBS) and the second stage uses importance sampling (IS). RBS is used to select a path from the butt of an object branch to a terminal segment. IS is used for selecting a disk that produces unbiased estimates of the fresh biomass of tree. In this study, the subsampling method was tested on 14 black pine sample trees (Pinus nigra Arnold subsp. pallasiana (Lamb.) Holmboe) in order to estimate the trees' biomass quickly and easily. Th e results showed a wide range of sampling error per tree, ranging from 2.51% to 22.63%. However, the sampling error for the total biomass of the 14 trees tested was only 2.65%. Th e proposed 2-stage sampling method generally performed better for the bole biomass than the branch biomass. Th ese results indicated that the proposed 2-stage sampling method is eff ective and might overcome many of the identifi ed constraints in biomass estimation. It is a viable alternative to the current methods used in Turkey.

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“…Various techniques (including open, 7,8 laparoscopic 9 and endourologic 10 approaches) have been described, usually in isolated case reports. In this case, we opted for a percutaneous approach because it was more definitive than a retrograde ureterorenoscopic approach and it spared the patient the morbidity of an open procedure.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous antegrade nephroscopic holmium laser pyelotomy: Novel endourologic technique for removal of extruded ureteral stent

Rhee

Steele

Beiko

2013

CUAJ

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Cite as: Can Urol Assoc J 2013;7(11-12):e830-2. http://dx.doi.org/10.5489/cuaj.1258 Published online December 5, 2013. AbstractUreteral stent malposition outside of the urinary tract is a very uncommon complication of retrograde or antegrade ureteral stent insertion. There are few reports of open, laparoscopic or endourologic approaches to remove malpositioned stents. We present a novel technique for the removal of an extruded retroperitoneal ureteral stent using percutaneous antegrade nephroscopic holmium laser pyelotomy. This previously undescribed procedure represents a new soft tissue application of the holmium laser. R etrograde or antegrade ureteral stent placement is a common practice to relieve upper urinary tract obstruction, pain, or infection.1 Minor complications of ureteral stents include pain, voiding symptoms, hematuria and infection, and major complications of stents include encrustation, fragmentation, migration, malposition, knot formation, forgotten stents, extrusion and death.1-3 Ureteral stent migration is rare and involves movement within the urinary system. Stent extrusion is extremely rare and involves movement outside of the urinary tract, sometimes into critical organs such as the inferior vena cava 4,5 or duodenum. 6Ureteral stent malposition is uncommon because of imaging techniques that are widely employed during stent placement. Ureteral stent malposition contained within the urinary tract lumen is often identified intraoperatively. However, malposition and extrusion of a ureteral stent outside of the urinary tract is extremely rare and may or may not be identified at time of stent insertion. We report a rare case of an antegrade malpositioned and extruded ureteral stent outside of the renal pelvis and its unique successful management via percutaneous antegrade nephroscopic holmium:yttrium aluminium garnet (YAG) laser pyelotomy -a procedure that has not been reported in the literature to date. Case reportA 78-year-old female presented with acute renal failure and bilateral hydronephrosis secondary to an obstructing, locally advanced and metastatic colorectal carcinoma. Serum creatinine was 922 μmol/L. Bilateral nephrostomy tubes and antegrade 8.5 Fr double J ureteral stents were placed by the interventional radiology service at our institution under ultrasonographic and fluoroscopic guidance. Within 3 days, the patient's creatinine returned to baseline (54 μmol/L) and both nephrostomy tubes were removed 5 days later. The patient was discharged in stable condition with indwelling bilateral ureteral stents. At initial follow-up 6 weeks after stent insertion, the patient reported mild intermittent gross hematuria, but no nausea or stent colic. Serum creatinine remained normal. Elective bilateral ureteral stent change was attempted under general anaesthesia 3 months later. Left-sided stent change was uneventful, despite a partially encrusted stent. The right-sided stent was not changed due to significant resistance that was met while attempting to remove it. The procedure was abandoned ...

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Retrovesical migration of malpositioned double-j ureteral stent

Abstract: A case of extraperitoneal migration of a double-J ureteral stent in the retrovesical space as a result of malposition is being described. The management of this very rare complication of stent placement, which has never been reported in the international literature, is presented in detail.

Cited by 12 publications

References 3 publications

Fluoroscopy-free double-J stent placement through ureteroscope working channel postuncomplicated ureteroscopic laser lithotripsy: A novel technique

Fluoroscopy-free double-J stent placement through ureteroscope working channel postuncomplicated ureteroscopic laser lithotripsy: A novel technique

Double-J stent placement with grasping forceps through ureteroscope working channel: a novel technique

Percutaneous antegrade nephroscopic holmium laser pyelotomy: Novel endourologic technique for removal of extruded ureteral stent

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