Kajbafzadeh Abdol-Mohammad, Nabavizadeh Behnam, Keihani Sorena, Hosseini Sharifi Seyed Hossein
Pediatric Urology Research Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, No. 62, Dr. Gharib's Street, Keshavarz Boulevard, PO Box 1419733151, Tehran, Iran,
Int Urol Nephrol. 2015 Jun;47(6):881-5. doi: 10.1007/s11255-015-0963-7. Epub 2015 Apr 3.
To propose a simple noninvasive method for ureteral stent retrieval using an extraction string sutured to the skin in children.
A retrospective chart review was performed to gather relevant data from December 2005 to February 2013. After the surgeries, if indicated, a tethered double-J stent was placed in the ureter. A 5-0 non-absorbable Prolene stitch was used as an extraction string passing through the urethra and was sutured to subcoronal skin in boys or inner surface of labia majora in girls. For stent removal, a small amount of 2 % lidocaine jelly was pushed into the urethra 5 min before the procedure. The string was then pulled by continuous and gentle force until the entire stent was out. The suture was then cut to release the stent. No sedation or anesthesia was needed.
A total of 378 double-J stents with extraction strings were inserted for a total of 325 patients (61.2 % male). Of the 53 patients with bilateral ureteral stents, one male patient (1.88 %) experienced early stent protrusion from urethral meatus. Two of 272 patients (0.73 %) with unilateral ureteral stent (one male and one female) encountered the same problem. All other stents were extracted successfully using the extraction string without any complications. No upward stent migration or suture site reaction was encountered.
This method is a safe, easy-to-use, feasible and noninvasive alternative for cystoscopic stent removal with high success rate and minimal complications. This can lead to considerable saving in time and costs for patients, families and healthcare system.
提出一种用于儿童输尿管支架取出的简单无创方法，该方法通过将取出线缝合至皮肤来实现。
进行回顾性病历审查，以收集2005年12月至2013年2月的相关数据。手术后，如有需要，在输尿管内放置一根带系绳的双J支架。使用一根5-0不可吸收的普理灵缝线作为取出线，使其穿过尿道，并缝合至男孩的冠状沟下皮肤或女孩的大阴唇内表面。在取出支架前5分钟，将少量2%利多卡因凝胶推入尿道。然后持续轻柔地拉动缝线，直至整个支架取出。随后剪断缝线以释放支架。无需镇静或麻醉。
共为325例患者（61.2%为男性）插入了378根带有取出线的双J支架。在53例双侧输尿管支架患者中，1例男性患者（1.88%）出现早期支架从尿道口突出的情况。在272例单侧输尿管支架患者（1例男性和1例女性）中有2例（0.73%）出现了同样的问题。所有其他支架均使用取出线成功取出，无任何并发症。未出现支架向上迁移或缝线部位反应。
该方法是一种安全、易用、可行且无创的替代膀胱镜下支架取出的方法，成功率高且并发症极少。这可为患者、家庭和医疗系统节省大量时间和成本。
