Self-Removing Antegrade Tethered Ureteric Stents After Tubeless Percutaneous Nephrolithotomy in the COVID-19 Era

Abstract

Purpose: To assess the safety and efficacy of self-removing antegrade tethered stents after percutaneous nephrolithotomy (PNL) during the COVID-19 pandemic. Materials and Methods: Instead of routine placement of double-J stent which requires endoscopic removal, a tethered antegrade stent after tubeless PNL as an exit strategy followed by self-removal can obviate the need of early postoperative revisit. A prospective observational study in a university teaching hospital was conducted during the lockdown period from May 2021–June 2021 with the use of antegrade tethered stent in 30 patients and we studied the complications associated with it. Results: The average stone size among the patients was 2.4 cm (1.2–4.9). Postoperative visual analog scale (VAS) till the time of stent removal was 30.8 + 4.4 mm while the VAS at stent removal was 26.6 + 3.8 mm. None of the patients had urine leak or hemorrhage from the site of percutaneous access after self-removal of stent. Two (6.66 percent) patients had grade I and grade II modified Clavien–Dindo complication. The mean score of satisfaction with life scale (SWLS) Questionnaire was 31 (34–27). The present study demonstrates that tubeless PNL with antegrade tethered stent has the advantages of avoiding hospital visits for stent removal during COVID-19. Conclusion: The use of an antegrade threaded stent is safe, culminating in minimal morbidity and patient distress, and greater overall patient satisfaction.