A Cheap Minimally Painful and Widely Usable Alternative for Retrieving Ureteral Stents

Söylemez, Haluk; Sancaktutar, Ahmet Ali; Bozkurt, Yaşar; Atar, Murat; Penbegül, Necmettin; Yıldırım, Kadir

doi:10.1159/000327610

Cited by 14 publications

(10 citation statements)

References 33 publications

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“…grasper. The maintenance interval for each instrument was 10 times with a repair cost of $1.487 and $491 for the flexible cystoscope and forceps respectively [17]. In a retrospective study, Canales et al showed that flexible cystoscopes required repair every 2 to 3 years over a four year study period.…”

Section: Discussionmentioning

confidence: 99%

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First clinical evaluation of a new single-use flexible cystoscope dedicated to double-J stent removal (Isiris™): a European prospective multicenter study

et al. 2016

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Section: Discussionmentioning

confidence: 99%

“…For the latter procedure, this requires a dedicated place with video equipment as well as cystoscopes and graspers. These instruments are fragile and have to be disinfected after each procedure, which may limit the number of procedures due to their availability [16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

First clinical evaluation of a new single-use flexible cystoscope dedicated to double-J stent removal (Isiris™): a European prospective multicenter study

et al. 2016

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“…Several reports have described endoscopic and non-endoscopic methods intended to reduce pain during cystoscopic stent removal or provide a substitute for the cystoscopic procedure. The ureteral stent extraction string is an alternative that can obviate the need for a cystoscopic procedure [ 1 – 6 , 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Rethinking of ureteral stent removal using an extraction string; what patients feel and what is patients' preference? : a randomized controlled study

et al. 2015

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BackgroundUreteral stent removal using an extraction string is advantageous because it can obviate an invasive cystoscopy, but there is a paucity of data on how patients feel about it, and how bothersome or beneficial it is.We performed this study to evaluate patients’ preference for stent removal using an extraction string and which parameters could affect it.MethodsIn total, 114 consecutive patients undergoing ureteral stent insertion after ureteroscopic stone removal (URS) for unilateral recurrent ureter stones were enrolled. Patients were randomized to a string group or a no string group.Stent removal was performed on the first visit within 7 days postoperatively. All patients were asked to complete the ureteral stent symptom questionnaire, to rate the degree of pain during stent removal using a visual analog scale (VAS) and to answer to questions regarding their preference.ResultsNo significant differences were found in domain total scores including urinary symptoms (p = 0.17), pain (p = 0.62), general health (p = 0.37), work performance (p = 0.41). However, regarding separate questions for ‘dysuria’ and ‘difficulties with heavy physical activity’, there were significant intergroup differences (p = 0.03 and p = 0.04, respectively). Particular, a significantly higher proportion of patients in the string group checked ‘stoppage of sexual intercourse due to stent-related problems’ than in the no string group (p = 0.03).VAS score on stent removal was significantly higher in the no string group than the string group (p = 0.005).Among the patients who remember the experience of an indwelling ureteral stent in the past, 85 % (17/20) of the no string group answered ‘No’ to the question of ‘difference between the methods used in this time and in the past’. On the contrary, 84.2 % (16/19) answered ‘Yes’ to the same question in the string group. And, all 16 patients of the string group who noted differences between the methods preferred ureteral stent removal using an extraction string to the past method.ConclusionsDespite of minor increased morbidity related to the extraction string, patients preferred ureteral stent removal using the extraction string after URS. The patients with the extraction string felt less pain on stent removal than flexible cystoscopic stent removal.Trial registrationKCT0001700. The trial was registered in the Clinical ResearchInformation Service (CRiS), Republic of Korea; registration date: 18/11/2015.

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“…Haluk et al described using rigid ureteroscopy for ureter stent retrieval as an alternative that can be less expensive than the flexible cystoscope and may be less painful than the rigid cystoscope [4]. We have been routinely using both the rigid ureteroscope and the flexible cystoscope for the stent retrieval in our center.…”

Section: Discussionmentioning

confidence: 99%

“…However, flexible cystoscope is associated with higher cost and may not be readily available in developing countries [3, 4]. Some reports have described experiences of using rigid ureteroscope to retrieve ureteral stents, especially in the occasional situations such as migrated or retained stents [4–6]. There has been no study published comparing the outcome between using a flexible cystoscope and a rigid ureteroscope for the ureteral stent removal.…”

Section: Introductionmentioning

confidence: 99%

A prospective and randomized comparison of rigid ureteroscopic to flexible cystoscopic retrieval of ureteral stents

et al. 2017

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BackgroundFlexible cystoscopy has become an accepted alternative for stent retrieval. However, it is associated with higher cost. Some reports have described experiences of using rigid ureteroscope to retrieve ureteral stents. We compared rigid ureteroscopic to flexible cystoscopic retrieval of ureteral stents in a prospective and randomized clinical trial.MethodsThree hundred patients treated with ureteral stents between July 2012 and July 2013 were accrued in this study. These patients were divided into two groups using the random number table method. Group A, with 162 patients, had stents removed with a flexible cystoscope and Group B, with 138 patients, had stents removed with a rigid ureteroscope. All procedures were performed under topical anesthesia by the same urologist. Patients in each group were compared in terms of preoperative, perioperative, and postoperative data. Postoperative data were collected using telephone interview on the postoperative day two. The postoperative questionnaire used included three items: hematuria, irritable bladder symptoms, and pain scores.ResultsAll the stents were retrieved successfully. No statistical differences were noted between the two groups in terms of gender, age, laterality and duration of the stents, operative time, postoperative hematuria, irritable bladder symptoms, and pain scores. The per-use cost of instrument was much higher for the flexible cystoscopic group, RMB 723.1 versus 214.3 (USD 107.9 versus 28.2), P < 0.05.ConclusionUreteral stent retrieval using rigid ureteroscope under topical anesthesia is as safe and effective as flexible cystoscope but with a much lower cost to patients.Trial registrationThis study was registered with Chinese Clinical Trial Registry on March 27, 2017 (retrospective registration) with a trial registration number of ChiCTR-IOR-17010986.

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A Cheap Minimally Painful and Widely Usable Alternative for Retrieving Ureteral Stents

Cited by 14 publications

References 33 publications

First clinical evaluation of a new single-use flexible cystoscope dedicated to double-J stent removal (Isiris™): a European prospective multicenter study

First clinical evaluation of a new single-use flexible cystoscope dedicated to double-J stent removal (Isiris™): a European prospective multicenter study

Rethinking of ureteral stent removal using an extraction string; what patients feel and what is patients' preference? : a randomized controlled study

A prospective and randomized comparison of rigid ureteroscopic to flexible cystoscopic retrieval of ureteral stents

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