PURPOSE: Ureteral stents are manufactured with an extraction string (string) tethered to the distal end, which facilitates removal after urologic surgery; however, the string may allow stent dislodgement.
Herein we report the stent dislodgement rate in a multi-institutional series.
MATERIALS AND METHODS: Ureteroscopy cases from three academic endourology practices were retrospectively reviewed. Demographic and operative data were obtained, as were string use and stent dislodgement. Categorical variables were assessed with Fisher's exact test, and the student's T test was used to assess continuous variables.
RESULTS: A total of 512 cases were performed and a string was used in 98 cases (19.1%). This included 41 females (41.8%) and 57 males (58.2%) with a string. Dislodgement occurred in 13 cases (10 women, 3 men). No dislodgements occurred when a string was not utilized. When stratified by gender, 5.3% of men and 24.4% of women with strings dislodged their stents (p =0.013). Women were more than four-fold more likely to dislodge their stents than men (RR 4.6, 95% CI 1.36 to 15.8, p = 0.01).
CONCLUSIONS: Nearly 15% of patients who have a stent placed with a string will sustain stent dislodgement, and the majority of these will be women. We recommend considering the risks of dislodgement for each patient who undergoes ureteroscopy with stent placement, and consideration of string removal if the surgeon feels dislodgement could result in adverse events such as severe colic or obstruction.
Written by:
Althaus A, Li K, Pattison E, Eisner B, Pais V, Steinberg P. Are you the author?
Brigham and Women's Hospital/Beth Israel Deaconess Medical Center Boston, MA; Massachusetts General Hospital Boston, MA; Dartmouth-Hitchcock Medical Center Lebanon, NH; Beth Israel Deaconess Medical Center Boston, MA.
Reference: J Urol. 2014 Dec 22. pii: S0022-5347(14)05141-6.
doi: 10.1016/j.juro.2014.12.087
PubMed Abstract
PMID: 25541339