Noncystoscopic removal of retained ureteral stents in children

Abstract

Cystoscopic technique is the current common method of retrieving double J ureteral stent in most pediatric urological centers. In this study, we evaluated the feasibility and efficacy of a novel noncystoscopic method to remove retained ureteral stents in pediatric patients.We reviewed all medical records from a total of 102 patients who were treated in our hospital between January 2013 and December 2016 to remove the double J ureteral stent retained into the ureter. The pediatric patients were divided into 2 groups based on different surgical options: cystoscopic group and noncystoscopic group. The surgery time (including time for instrument preparation), operation time, expenses, postoperative urination discomfort, and hospitalization were compared between the 2 groups.The noncystoscopic group took significantly less time for surgery and operation than the cystoscopic group (surgery time:7.40 ± 3.75 vs 18.42 ± 2.77 min, P <.05; operation time: 3.54 ± 2.03 vs 4.48 ± 2.04 min, P <.05). The mean spending for patients in the noncystoscopic group were less than that in the cystoscopic group ($736.70 ± 105.96 vs $618.23 ± 110.31, P <.05). There were less children with postoperative urination discomforts in the noncystoscopic group than that in the cystoscopic group (8 vs 20 cases, χ2 = 4.241, P <.05). The mean hospitalization of the noncystoscopic group was shorter than that of the cystoscopic group (3.20 ± 1.25 vs 4.13 ± 1.63 d, P <.05). The differences in all comparison projects were significant.The noncystoscopic procedure is a safe and viable technique that may be used successfully in pediatric urology. This novel procedure which is much safer and more affordable provides an alternative solution to remove retained ureteral stents in child patients.

Trans‐urethral snare stent removal: a novel, self‐constructed innovation for simultaneous ureteral stent removal and safety guidewire insertion

“…utilized the suture attached to a feeding tube (Vellore Catheter Snare) 23 . Similar results were observed in the non‐cystoscopic attempt of stent removal using a Lasso technique with success in boys and girls (97 and 41, respectively), 24 and again in 45 of 47 children 25 . The advent of blind ureteral stent removal has also been performed using a three‐way urethral catheter snare created from a looped guidewire 26 …”

Feasibility and Safety of a Simple Non-cystoscopic Double-J Tube Removal Technique in Children

“…In this study, we reported a non-cystoscopic technique for double-J tube removal with a simple device of only a suture and one catheter. Our method has been reported in previous literature, such as the Vellore Catheter Snare technique ( 7 ) along with two similar techniques reported by Lin et al ( 8 ) and Shao et al ( 9 ). These studies have revealed that non-cystoscopic double-J tube removal had a shorter operation time and lower cost compared to that of a cystoscopic approach ( 7 – 9 ).…”

“…Our method has been reported in previous literature, such as the Vellore Catheter Snare technique ( 7 ) along with two similar techniques reported by Lin et al ( 8 ) and Shao et al ( 9 ). These studies have revealed that non-cystoscopic double-J tube removal had a shorter operation time and lower cost compared to that of a cystoscopic approach ( 7 – 9 ). However, these studies were performed with small sample size.…”

“…Lin et al (8) reported 138 cases of the cystoscopic vs. non-cystoscopic technique with a mean operation time of 12.57 min vs. 5.05 min for male patients and 9.61 min vs. 4.63 min for female patients, respectively. Furthermore, Shao et al (9) validated that the non-cystoscopic technique had a shorter operative time than that of the cystoscopic approach (7.40 ± 3.75 vs. 18.42 ± 2.77 min, respectively, P < 0.05). In addition, the mean cost for patients in the non-cystoscopic group was less than that for patients in the cystoscopic group ($736.70 ± 105.96 vs. $618.23 ± 110.31, respectively, P < 0.05).…”

“…In clinical settings, re-sterilisation is required every time the equipment is used, preparation time for surgery is long, and the cost of maintenance is high. The present study used references from previous studies (7)(8)(9). In this procedure, a skilled clinician can have a high success rate and remove the tube in the first attempt.…”