Objective
To test the feasibility of ureteral stent placement without image guidance after uncomplicated
ureteral stone removal and to compare the outcomes of fluoro-less and conventional
ureteral stent placement.
Methods
A technique was devised to allow placement of a ureteral stent without image guidance
by substituting fluoroscopy with visual and tactile cues. A retrospective review of
25 patients using fluoro-less stent placement was compared with 25 consecutive patients
who underwent conventional stent placement with fluoroscopy. Stent placement was graded
on a 6-point scale to assess coil symmetry and location. Comparisons between the fluoro-less
stent placements and controls were performed with the Mann-Whitney U test. All hypotheses were 2-sided and conducted at an alpha level of 0.05.
Results
All 25 ureteral stent placements were performed successfully without the use of fluoroscopy
for image guidance. There was no significant difference in age, gender, body mass
index, stone size, or complication rates when fluoro-less and conventional stent placements
were compared. In addition, grade 1 placement was achieved in 76% of the fluoro-less
group and in 64% of the conventional group. Although placement accuracy was higher
in the fluoro-less group this was not statistically significant (P = .13).
Conclusion
Ureteral stent placement without fluoroscopic guidance is feasible. It maintains comparable
efficacy and complication rates with conventional ureteral stent placement. This technique
allows reduced radiation exposure in patients requiring ureteral stent placement.
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Article info
Publication history
Published online: August 29, 2012
Accepted:
June 23,
2012
Received:
February 19,
2012
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Re: Brisbane et al.: Fluoro-less Ureteral Stent Placement Following Uncomplicated Ureteroscopic Stone Removal: A Feasibility Study (Urology 2012;80:766-770)UrologyVol. 81Issue 2
- PreviewWe congratulate the authors for describing a novel technique of “fluoro-less” ureteral stent placement after uncomplicated ureteroscopic stone removal. However, certain queries need clarification. First, the need to place a double-J stent routinely after uncomplicated ureteroscopy is unnecessary.1,2 Second, the authors have determined the stent position by visualizing the upper stent coil with the renal outline on postoperative plain films taken at the follow-up visit. However, the authors do not mention the time of the first follow-up visit.
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