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【Objective】 To compare the clinical efficacy of double and triple D-J ureteral stents in the treatment of benign secondary ureteral stricture. 【Methods】 Clinical data of 58 patients with benign secondary ureteral stricture treated at our hospital during Dec.2018 and Aug.2021 were retrospectively analyzed. According to the number of D-J ureteral stents, the patients were divided into the double group (n=29) and triple group (n=29). The clinical efficacy, complications during catheterization, and fluctuations of serum creatinine and hydronephrosis volume were compared and analyzed between the two groups. 【Results】 There were no significant differences in the general data, catheter duration and follow-up between the two groups (P>0.05). The triple group had more reduction of hydronephrosis than the double group [-22.8(32) cm3vs. -7.4(12) cm3, P=0.001] . There were no significant differences in the change of serum creatinine [-8.0(15)μmol·L-1 vs. -4.0(15) μmol·L-1, P =0.657] and incidence of complications (34.4% vs. 41.4%, P=0.588) between the two groups. The triple group had higher total effective rate than the double group (93.1% vs. 86.2%), but the difference was not statistically significant (P=0.666). There was no significant difference in the efficacy of balloon dilatation between the two groups (100.0% vs. 90.9%, P=0.407). 【Conclusion】 Both double and triple D-J ureteral stents are safe and effective in the treatment of benign secondary ureteral stenosis, but three D-J ureteral stents can better reduce hydronephrosis. Clinicians can choose appropriate indwelling scheme according to patients’ condition.
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Objective To investigate the duration of indwelling ureteral stent after the ureteroscopic lithotripsy.Methods 300 cases of patients were retrospectively analyzed from June 2015 to June 2017,including 168 with renal calculi and 132 with non-incarcerated upper ureteral calculi.The size of stone is ＜2 cm in diameter.According to the length of time for indwelling ureteral stent,all patients were divided into two groups-150 cases in 14-day group (Group A) and 150 in the 28-day group (Group B) for comparing the complication and outcome,and then received modular flexible ureteroscopic lithotripsy combined with holmium laser.Lastly,6F ureteral stent was indwelling postoperatively.Results Complications happened in both two groups after stenting.There were 140 cases (93.3％) complained of bladder irritation symptoms (LUTS) in Group A,while 107 (71.3％) in Group B;85 cases (56.7％) suffered from flank or abdominal pain in Group A and 36 (24％) in Group B;gross hematuria happened in 133 cases (88.7％) of Group A and 60 cases (40％) of Group B.As the duration of indwelling ureteral stent extended,the incidence of complications increased,significantly (P ＜ 0.05).CT scan showed there was no statistical difference in stone-free rate (diameter ＜ 3 mm) of two groups [A group:91.3 ％ (137/150) vs.B group:89.3 ％ (134/150),respectively].Conclusion With high stone-free rate and low complication incidence,2-week indwelling ureteral stent is safe for patients suffered from renal calculi or non-incarcerated upper ureteral calculi (diameter ＜ 2 cm).
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Artificial conduits, including ureteral stents and catheters, are used widely as drainage tools in the urinary system. However, various bacteria in the urine and long duration of insertion can arouse the biofilm formation on the pipeline surface, which calls for effective antibacterial strategy. In this article, the mechanism of Catheter Associated Urinary Tract Infections (CAUTI) is explained from the perspective of etiology. Then, the biofilm formation conditions and the features of urine are analyzed, the antibacterial agents and approaches suitable for ureteral stents and catheters are introduced and their pros and cons are discussed respectively.
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Humanos , Antibacterianos , Catéteres , Drenaje , Stents , Cateterismo Urinario , Infecciones UrinariasRESUMEN
Objectives: Ureteral stenting is a common intervention in endourological procedures. Despite the usefulness of stents, patients may experience various stent-related symptoms. These symptoms can have a significant impact on patients’ health related quality of life. There are several medical modalities for symptom improvement and Phosphodiesterase 5 Inhibitors are recent therapeutic option. This study is designed to evaluate the effects of Tadalafil on alleviation of stent associated symptoms measured by Ureteral Stents Symptom Questionnaire. Design: In this Randomized Controlled Trail patients were randomly assigned to an intervention or Placebo group by a computer based random block design. Patients received encoded drug packages from a central call system. Physicians, patients and statistical analyzers were not aware of the designated intervention. Setting and Conduct: Patients received treatment with Tadalafil or placebo for four weeks after ureteral stent insertion and completed a follow up session four weeks after the intervention. Participants: Male patients who underwent unilateral ureteral stenting in Imam Reza hospital in Tabriz, Iran were enrolled in this study. Patients with history of hypertension, heart and/or respiratory disease, stroke, hypotension, renal failure, consumption of nitrate drugs and a positive urine culture or who had any allergic reaction to Tadalafil were excluded. Interventions: Patients were allocated to receive Tadalafil 10 mg or Placebo daily for four weeks. Outcome Variables: The primary outcome variables were stent related symptoms (urinary symptoms, pain, general health, sex and working status). Secondary outcomes included possible side effects such as cardiovascular, respiratory, gastrointestinal, musculoskeletal and central nervous system problems.
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Objective To investigate the effect of indwelling double-J ureteral stents before flexible ureteroscope lithotrity in terms of operation time, postoperative hospitalization time and operation effect. Methods All clinical data of flexible ureteroscope lithotrity from 2009 to 2013 were reviewed. Operation time, postoperative hospitalization time and recurrence rate of calculus of patients who received operation directly and patients who received indwelling of double-J ureteral stents 2 weeks before operation were observed and compared. Results Op-eration time, postoperative hospitalization time, and recurrence rate of calculus of patients who received indwelling of double-J ureteral stents 2 weeks before receiving operation were obviously lower than patients who received operation directly. Conclusion Operation time, postoper-ative hospitalization time and recurrence rate of calculus can be decreased by indwelling double-J ureteral stents 2 weeks before operation.
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Objective To evaluate the curative effect of metallic stent placed for malignant and chronic benign ureteral obstruction. Methods From October 2013 to April 2014, 10 patients were given placement of the metallic stents for treatment of malignant ureteral ob-struction and chronic benign ureteral obstruction in our institutionl. ECT was performed to test split kidney function after metallic stents placement. Results After the mean follow-up time of 4 months ( ranged from 1 to 7 months) , unilateral renal function improved in 11 cases. And there was no decrease of kidney function among all the patients who were given placement of the metallic stents. Conclusion Metallic stent is a valuable treatment for releasing the malignant and chronic benign ureteral obstruction.
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Objective:This study aimed to analyze the prognostic factor of bilateral hydronephrosis caused by advanced cervical cancer and evaluate its value of treatment. Methods:A total of 40 patients with bilateral ureteral obstruction secondary to cervical cancer were diagnosed through computerized tomography, radioactive nephrogram, and blood tests for renal function. The placement of retrograde internal double-J ureteral stents was performed under a cystoscope in 13 patients. The placement of antegrade internal double-J ureteral stents via percutaneous nephrostomy was performed in 25 patients. Two cases had external ureteral stents via percutaneous nephrostomy. Twenty-nine patients underwent radiotherapy after normalization of their blood urine nitrogen and creatinine levels. The prognostic value of the treatment and renal function before placement of ureteral stents and radiotherapy after placement of ureteral stents were analyzed. Results:The normalization rate of renal function after ureteral stenting was 91.3%(21/23). The median survival time was longer in patients with untreated cervical cancer than that in patients with recurrent cervical cancer (χ2=9.379, P=0.009). After ureteral stenting, the median survival time was longer in patients who underwent radiation therapy than that in patients untreated with radiation (χ2=17.329, P=0.000). The median survival time was not significantly influenced by renal function before placement of ureteral stents (χ2=1.37, P=0.242). Conclusion:The patient with bilateral ureteral obstruction from untreated cervical cancer or from recurrent pelvic disease after surgical therapy should be considered for ureteral stenting followed by appropriate radiation.
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A series of six patients with "forgotten and fragmented" internal ureteral stents, seen and managed at the National Kidney Institute, is presented to illustrate the variable, unpredictable, and at times hazardous course of such patients. The "forgotten" period of the internal indwelling stents ranges from one year to ten years. All of the six patients necessitated a combined endourological and open surgical treatment. Two of the six patients eventually had a nephrectomy. One patient had a cardio-pulmonary arrest during the procedure designed to retrieve the fragmented segments. These cases were cited to increase awareness among Urologists in practice and residents in training of the dire consequences of a "forgotten" internal ureteral stent. It is important to explain to the patient that he/she has an indwelling stent that must be removed or replaced within a particular period of time. A separate record of patients should include data that will enable the Urologist to contact the patient when the need arise. A separate informed consent sheet providing a copy to both the institution and patient may be necessary to protect the hospital from legal complaints.(Author)