Safety and Efficacy of Ureteral Stent Placement at the Bedside Using Local Anesthesia

Abstract

In our cohort bedside ureteral stent placement was well tolerated, safe and efficacious, thus expediting upper tract decompression in the setting of obstructed renal units in more than 70% of patients.

Managing change in the urology department of a large hospital in Italy during the COVID‐19 pandemic

“…A total of 32 out of 426 (7.5%) planned visits were carried out. 5 Laparoscopic and robot-assisted procedures continued to be carried out using some precautions (the use of a continuous circulation of insufflation, the minimization of the gas leakage around the ports by matching skin incision with port size and the use a low-pressure pneumoperitoneum), 6 despite some evidence suggesting that laparoscopy can cause a higher concentration of surgical smoke in the abdomen and cause viral aerosolization. 7 In our population, anxiety of COVID-19 has spread faster than the virus.…”

“…In all cases, we used a modified Studer NB, a "heart-like" spheroidal-shaped reservoir designed by Bianchi et al 5 With the double-pulling technique, we modified our previous single-pulling technique to facilitate intracorporeal NB-urethral anastomosis, as described below. 4 Before the NB is placed in the pelvic space, two 70-cm 2-0 monofilament polypropylene sutures are placed securely at the 5 and 7 o'clock positions, using 6-cm straight needles, but are not tied.…”

Where do urologists stand in the era of novel coronavirus-2019 disease

“…Careful consideration should be given to which procedure is chosen as nephrostomy under local anaesthetic can spare a ventilator [44]. In centres with suitable experience, ureteric stenting under local anaesthetic in the outpatient setting can be considered [45]. Definitive stone surgery can then be postponed for a few weeks.…”

Live Renal Ultrasonography Facilitates Double-J Ureteral Stent Insertion at the Bedside: A Pilot Study for the COVID-19 Era

“…First described by Clayman and Kramolowsky in 1986, 1 bedside ureteral stent placement was shown in a larger series by Nourparvar and colleagues in 2016 to be safe and well tolerated using local anesthesia only. 2 The success rate was 71% without image guidance, and unsuccessful stent placement at bedside required immediate follow-up intervention in the operating room. Despite the modest success rate, the benefit of performing bedside ureteral stent placement was underscored by a cost analysis showing the bedside procedure is up to 10-fold less costly compared with the same procedure done in the operating room.…”

“…Despite the modest success rate, the benefit of performing bedside ureteral stent placement was underscored by a cost analysis showing the bedside procedure is up to 10-fold less costly compared with the same procedure done in the operating room. 2,3 We sought to evaluate live renal ultrasonography as an imaging tool to enhance the success rate of bedside ureteral stent placement. Modern ultrasound can provide high-quality observation capable of accurately assessing wire and stent position, but it has generally been reserved for special situations when fluoroscopy is contraindicated, such as pregnancy.…”