PD7-03 RATE OF ACCIDENTAL DISLODGEMENT OF URETERAL STENTS WHEN UTILIZING AN EXTRACTION STRING AFTER ENDOSCOPIC UROLOGIC SURGERY

Abstract

You have accessJournal of UrologyStone Disease: Therapy I1 Apr 2014PD7-03 RATE OF ACCIDENTAL DISLODGEMENT OF URETERAL STENTS WHEN UTILIZING AN EXTRACTION STRING AFTER ENDOSCOPIC UROLOGIC SURGERY Adam Althaus, Kai Li, Erik Pattison, Brian Eisner, Vernon Pais, and Peter Steinberg Adam AlthausAdam Althaus More articles by this author , Kai LiKai Li More articles by this author , Erik PattisonErik Pattison More articles by this author , Brian EisnerBrian Eisner More articles by this author , Vernon PaisVernon Pais More articles by this author , and Peter SteinbergPeter Steinberg More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.692AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Ureteral stents are manufactured with extraction strings (string) for easy removal after endoscopic urologic surgery; however, the string allows inadvertent stent dislodgement. The rate of string use and accidental dislodgement after ureteroscopy and cystoscopy is poorly characterized, and this study’s aim was to better quantify both rates. METHODS All ureteroscopy and cystoscopy cases from two endourology practices (VMP and BE) were reviewed over 12-months. Baseline demographic data was obtained, as were laterality, operative time, blood loss, string use and inadvertent dislodgement. Categorical variables were assessed with the Fisher’s exact test to identify risk factors for dislodgement. RESULTS A total of 409 cases were performed and a string was used in 53 cases (12.9%), including 23 females and 30 males. The average age of patients with a string was 52 ± 17. Accidental dislodgement occurred in 7 cases (13% of cases with a string and 1.7% of all cases), 5 female and 2 male. No accidental dislodgements occurred when a string was not utilized. Six of the seven cases were ureteroscopy for renal or ureteral stones, and one cases was removal of a retained stent. Their average age was 48 ± 15. The presence of a string on the stent had a statistically significant association with dislodgement (p < 0.0001). Dislodgement occurred on POD 0 in 5 patients, POD 2 in 1 patient and at an unknown time in 1 patient. Two patents pulled their stent in the recovery room; two accidentally pulled their stent out at home; one stent fell out while the patient showered; one patient intentionally removed his stent; and in one case the cause of dislodgement was not known. With early dislodgement, 2/7 (28% of patients with dislodgement and 3.7% of all patients with a string) patients had complications: one with flank pain that resolved (Clavien 1) and one with flank pain requiring intravenous analgesia (Clavien 2). CONCLUSIONS Use of a string on a ureteral stent is a risk factor for accidental stent dislodgement. The rate of inadvertent dislodgement is 13% in this series and 28% of patients with early dislodgement had a complication. This data will guide clinicians on the risks associated with string use and allow better counseling of patients regarding the outcome of having a string stent. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e184 Peer Review Report Advertisement Copyright & Permissions© 2014MetricsAuthor Information Adam Althaus More articles by this author Kai Li More articles by this author Erik Pattison More articles by this author Brian Eisner More articles by this author Vernon Pais More articles by this author Peter Steinberg More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...