Department of Urology, Ohguchi Higashi General Hospital, Yokohama, Kanagawa, Japan.
PLoS One. 2012;7(1):e29292. doi: 10.1371/journal.pone.0029292. Epub 2012 Jan 3.
We developed a method for ureteral stent removal in female patients that requires no cystoscopy or fluoroscopic guidance using a crochet hook. In addition, we also investigated the success rate, complications and pain associated with this procedure.
A total of 40 female patients (56 stents) underwent the removal of ureteral stents. All procedures were carried out with the patients either under anesthesia, conscious sedation, or analgesic suppositories as deemed appropriate for each procedure including Shock Wave Lithotripsy (SWL), Ureteroscopy (URS), Percutaneous Nephrolithotomy (PCNL), and ureteral stent removal. At the time of these procedures, fluoroscopy and/or cystoscopy were prepared, but they were not used unless we failed to successfully remove the ureteral stent using the crochet hook. In addition, matched controls (comprising 50 stents) which were removed by standard ureteral stent removal using cystoscopy were used for comparison purposes.
A total of 47 of the 56 stents (83.9%) were successfully removed. In addition, 47 of 52 (90.4%) were successfully removed except for two migrated stents and two heavily encrusted stents which could not be removed using cystoscopy. Ureteral stent removal using the crochet hook technique was unsuccessful in nine patients, including two encrustations and two migrations. Concerning pain, ureteral stent removal using the crochet hook technique showed a lower visual analogue pain scale (VAPS) score than for the standard technique using cystoscopy.
Ureteral stent removal using a crochet hook is considered to be easy, safe, and cost effective. This technique is also easy to learn and is therefore considered to be suitable for use on an outpatient basis.
我们开发了一种在女性患者中使用钩针移除输尿管支架而无需膀胱镜或透视引导的方法。此外，我们还研究了该程序的成功率、并发症和相关疼痛。
共有 40 名女性患者（56 个支架）接受了输尿管支架的移除。所有程序均在麻醉、镇静或镇痛栓剂下进行，具体取决于每个程序，包括体外冲击波碎石术（SWL）、输尿管镜检查（URS）、经皮肾镜取石术（PCNL）和输尿管支架移除。在进行这些程序时，准备了透视和/或膀胱镜检查，但除非我们未能成功使用钩针移除输尿管支架，否则不会使用它们。此外，还使用了使用膀胱镜检查标准移除输尿管支架的匹配对照组（包括 50 个支架）进行比较。
总共 56 个支架中的 47 个（83.9%）成功移除。此外，除了两个迁移的支架和两个无法使用膀胱镜移除的严重结壳支架外，52 个中的 47 个（90.4%）成功移除。使用钩针技术移除输尿管支架在 9 名患者中不成功，包括 2 例结壳和 2 例迁移。关于疼痛，使用钩针技术移除输尿管支架的视觉模拟疼痛量表（VAPS）评分低于使用膀胱镜检查的标准技术。
使用钩针移除输尿管支架被认为是简单、安全且具有成本效益的。该技术也易于学习，因此被认为适合在门诊基础上使用。
