Document Detail


Ureteral Stents for Impassable Ureteroscopy.
MedLine Citation:
PMID:  23066997     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: For the narrow ureter that will not accommodate a ureteroscope, it is common practice to place a ureteral stent to allow subsequent ureteroscopy in the passively dilated ureter. Surprisingly, there are limited data on the effectiveness or safety of these maneuvers. Methods: We retrospectively analyzed patients managed with ureteral stent placement followed by another attempt at ureteroscopy after an initial attempt of flexible ureteroscopy failed because the ureteroscope would not pass up an otherwise normal ureter. Results: Of 41 patients with follow-up who underwent ureteral stenting for this reason, the ureteroscope passed with ease post-stenting in 29 (71%) and there was continued resistance in 12. Of these 12 patients, the ureteroscopy was continued despite resistance in 9, while another stent was placed in the remaining 3. Of these 3 patients, the third attempt at ureteroscopy was successful in 2, and further attempts at ureteroscopy were not made after the third attempt failed in 1. With a mean overall follow-up of 32 months, 2 patients (5%) developed ureteral strictures. Both were among 9 patients in whom repeat ureteroscopy was performed despite resistance, with a rate of obstruction of 22% in this subgroup. Overall, ureteral stenting allowed successful ureteroscopy in 98% of patients. Conclusions: Ureteral stenting with subsequent ureteroscopy is a successful and safe method of addressing a narrow ureter that initially does not allow passage of a flexible ureteroscope, as long as persistent subsequent attempts to insert the ureteroscope are made only if it passes easily.
Authors:
Sapan Nitin Ambani; Gary J Faerber; William W Roberts; John M Hollingsworth; J Stuart Wolf Jr
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-15
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  -     ISSN:  1557-900X     ISO Abbreviation:  J. Endourol.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
University of Michigan, Urology, 1500 E. Medical Center Dr., Ann Arbor, Michigan, United States, 48109, 517-414-6390; sapan@med.umich.edu.
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