Ureteral Stent Discomfort and Its Management

Fischer, Katherine M.; Louie, Michael K.; Mucksavage, Phillip

doi:10.1007/s11934-018-0818-8

Cited by 51 publications

(35 citation statements)

References 50 publications

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“…Ureteral stent is the most commonly used medical implant for urological surgery. It is widely used in clinical practice because it can relieve urinary tract obstruction, drain urine, and protect renal function [14,15]. After PCNL operation, ureteral stent is usually retained for 4-6 weeks, but some patients need to keep ureteral stent for a long time because of the complex condition.…”

Section: Discussionmentioning

confidence: 99%

Study on risk factors, bacterial species, and drug resistance of acute pyelonephritis associated with ureteral stent after percutaneous nephrolithotomy

Jiang¹,

Jiang²,

et al. 2020

Eur J Clin Microbiol Infect Dis

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The purpose of this study is to explore the risk factors, bacterial species, and drug resistance of acute pyelonephritis (AP) associated with ureteral stent after percutaneous nephrolithotomy (PCNL) and to provide reference for clinical intervention. The clinical data of 415 patients with indwelling ureteral stent after PCNL from December 2016 to May 2019 were analyzed retrospectively. The patients were divided into infection group (n = 54) and non-infection group (n = 361) according to whether patients had AP. Patients’ clinical data, blood and urine bacterial culture, and drug sensitivity were collected and analyzed. The incidence of AP associated with ureteral stent after PCNL was 13.01% and diabetes mellitus (P = 0.001), postoperative stone residue (P = 0.002), urinary leucocytes ≥ 100/HP (P = 0.018), positive urine culture results (P = 0.001), ureteral stent retention time ≥ 8 weeks (P = 0.004), and high S.T.O.N.E. score (P = 0.014) are independent risk factors for it. Escherichia coli (40.54%, 47.82%), Klebsiella pneumoniae (16.21%, 15.21%), Pseudomonas aeruginosa (10.81%, 4.34%), Enterococcus faecalis (21.6%, 19.56%), and epidermis Staphylococci (10.81%, 13.33%) are the main pathogens in blood and urine. The main sensitive drugs of pathogenic bacteria are imipenem, meropenem, tigecycline, piperacillin/tazobactam, ceftazidime, linezolid, teicoplanin, levofloxacin, vancomycin, tigecycline, etc., while levofloxacin, norfloxacin, penicillin G, first, and second-generation cephalosporins showed a strong drug resistance rate (> 70%). This study found that diabetes, postoperative stone residuals, urinary leukocytes ≧ 100 cells/HP, positive urine culture results, ureteral stent indwelling time ≧ 8 weeks, and high S.T.O.N.E. score were independent of AP associated with ureteral stent after PCNL risk factors and Escherichia coli is the main pathogenic bacteria and shows drug resistance.

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Section: Discussionmentioning

confidence: 99%

Study on risk factors, bacterial species, and drug resistance of acute pyelonephritis associated with ureteral stent after percutaneous nephrolithotomy

Jiang¹,

Jiang²,

et al. 2020

Eur J Clin Microbiol Infect Dis

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“…As the prevalence of stent-related symptoms such as flank pain and irritative voiding symptoms is relatively high [9], the necessity of stenting a reimplanted ureter is under debate. Brandell et al [10] reviewed 34 patients with VUR who underwent laparoscopic ureteral reimplantation (LUR), of which 20 patients were "stentless."…”

Section: Discussionmentioning

confidence: 99%

A Modified Transurethral Stenting Technique for (Robot-Assisted) Laparoscopic Ureteral Reimplantation

Teng

Jia

et al. 2019

Urol Int

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Background: Ureteral stenting is a technique-demanding procedure performed during robot-assisted laparoscopic ureteral reimplantation (RALUR). Many stenting techniques have been reported; however, none of them could be accepted as an ideal way. Objectives: The aim of the study was to report our initial results of a modified stenting technique for RALUR. Methods: Consecutive 4 patients undergoing RALUR were prospectively enrolled into our study. Our ureteral stenting technique included the following steps: catheterize a head-cut Foley catheter at the beginning of the operation, drag out the Foley catheter from the ureterovesical stoma after finishing posterior anatomosis, insert a guide wire through the catheter to the ureter lumen, and place the double-J (DJ) stent over the guide wire with a pusher. Results: All surgeries were successfully performed without severe complications. The mean stenting time was 1.6 min. No submucosa pseudocanal was found during stenting. DJ stent was removed 4 weeks after surgery. During the 3-month follow-up, it was observed that no vesicoureteral reflux or ureter stricture was found. Conclusions: Our ureteral stenting technique is an effective, simple, and safe procedure in RALUR, and could also be performed in laparoscopic ureteral reimplantation.

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“…Considering the stent symptoms, it is a difficult condition to treat, as the mechanism is not well known, and treatment includes alpha‐blockers, anticholinergics, anti‐inflammatory medications and narcotic pain medications . In contrast, a retrospective study has shown that a postoperative ureteral stent is not necessary after fURS using an access sheath in pre‐stented patients, leading to the thought of not inserting a stent, which could avoid patients having stent symptoms, as well as preventing forgotten stents…”

Section: Ureteroscopy and Retrograde Intrarenal Surgerymentioning

confidence: 99%

Updates in endourological management of urolithiasis

Teoh

2018

Int J of Urology

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Urinary stone disease, or urolithiasis, is a very common disease with increasing prevalence and incidence. With the advancement of endoscopic techniques, the treatment outcomes of ureteroscopy (or transureteral lithotripsy) and percutaneous nephrolithotomy are continuously improving. In recent years, there have been many new developments in the field, including new endoscopy design, more effective auxiliary tools, improvement in treatment protocols, introduction of robotic technology, combining both ureteroscopy and percutaneous nephrolithotomy (endoscopic combined intrarenal surgery or transureteral lithotripsy‐assisted percutaneous nephrolithotomy), improvement in laser technology, and so on. All these new inputs will further improve the treatment efficacy and safety of the procedures, thus benefiting our patients. In the present review, we briefly go through the main steps of ureteroscopy and percutaneous nephrolithotomy, with a concise description and application of these new advances.

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Ureteral Stent Discomfort and Its Management

Cited by 51 publications

References 50 publications

Study on risk factors, bacterial species, and drug resistance of acute pyelonephritis associated with ureteral stent after percutaneous nephrolithotomy

Study on risk factors, bacterial species, and drug resistance of acute pyelonephritis associated with ureteral stent after percutaneous nephrolithotomy

A Modified Transurethral Stenting Technique for (Robot-Assisted) Laparoscopic Ureteral Reimplantation

Updates in endourological management of urolithiasis

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