Use of the Double Pigtail Stent in Stone Retrieval following Unsuccessful Ureteroscopy

Abstract

Insertion of a double pigtail stent is known to cause ureteric dilatation. We analysed the effect of an indwelling double pigtail stent on the success rate of calculus extraction by second ureteroscopy when the initial ureteroscopy fails. Over a 12-month period, a first ureteroscopy failed in 42 patients; 30 were then treated by ureteroscopy combined with a ureteric stent and 12 were treated without a ureteric stent. The group with an indwelling stent had a successful second ureteroscopy or spontaneously passed the calculus in 24 cases (84%) compared with 5 unstented cases (45%). Ureterolithotomy was necessary in 2 patients with a stent and 3 with no stent. It was concluded that following failed ureteroscopic manipulation of calculi, insertion of a double pigtail stent was associated with a higher subsequent success rate for removal of stone by ureteroscopy and a consequent lower rate of ureterolithotomy.

Ureteroscopy in the Treatment of Ureteral Stones: Over 10 Years’ Experience

“…In recent years, URS has been performed under the guidance of a video-camera, which in our opinion ensures better safety of the procedure. According to Netto et al [7]and contrary to Jones et al [16], we are absolutely convinced there is no need of dilatation of the vesical orifice of the ureter before each URS, or splinting of the ureter after the procedure. When applying the ‘Netto maneuver’ on the introduction of the ureteroscope on guide wire, there have been no cases when dilatation of the orifice was necessary [7].…”

Semi-rigid ureterorenoscopy in children without ureteral dilatation

“…Twenty-five of the stones were localized in the lower ureter, 16 in the mid-ureter, and 3 in the upper ureter. The mean stone size was found to be 7.1 mm [4][5][6][7][8][9][10][11][12]. None of the stones had migrated to the proximal region.…”

Double-Pigtail Stents for Distal Ureteral Calculi: An Alternative Form of Definitive Treatment

“…Stents arc known to cause ureteric dilatation, but the mechanism by which this occurs is not fully understood [9], Nevertheless, this phenomenon facilitates ureteric instrumentation. Jones et al [10] reported a 70% success rate in passing the ureteroscope at a second attempt after double-pigtail stent placement. The likelihood of calculus extraction at the second attempt is also increased [3,10], In addition, spon taneous passage of a stone with the stent in situ may occur [10].…”

“…Jones et al [10] reported a 70% success rate in passing the ureteroscope at a second attempt after double-pigtail stent placement. The likelihood of calculus extraction at the second attempt is also increased [3,10], In addition, spon taneous passage of a stone with the stent in situ may occur [10]. Also, Loughlin and Bailey [11] have reported on the case of a pregnant woman, whose upper ureteral stone passed spontaneously after removal of a stent inserted several weeks before delivery.…”

“…They allow temporary drainage of the obstructed urinary tract and facilitate stone localiza tion, subsequent passage of stone fragments and postsurgical drainage [8]. Stents cause ureteral dilatation [9], and spontaneous passage of ureteral calculi after stent place ment often occurs [10]. Based on this observation, we KARGER.…”