Fluoroscopy-Guided Transurethral Removal and Exchange of Ureteral Stents in Female Patients: Technical Notes

Abstract

To describe simple and safe techniques for transurethral removal and for exchange of ureteral stents in female patients under fluoroscopic guidance. During a period of 33 months, the authors removed 4 and exchanged 34 double-J ureteral stents in 17 female patients. Four techniques were implemented to remove or exchange these stents: simple snare technique, modified snare technique, guide-wire lasso technique, and direct grasping technique. All stents were either exchanged or removed successfully. The average time elapsed per procedure was 21.5 minutes. Simple snare techniques were used with 19 (50%) stents, and modified snare techniques were used with 13 (34%) stents where grasping the tip of a stent was not possible with the snare alone. Lasso and direct grasping techniques were each used with three (8%) stents. Self-limited microscopic hematuria was observed in all subjects after the procedure, but none reported gross hematuria. Fluoroscopy-guided transurethral removal and exchange of ureteral stents is a safe and effective procedure, and it can be considered as an alternative to cystoscopic removal and exchange.