Department of Urology, University Hospital of Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK.
Department of Urology, Tenon Hospital, University Pierre and Marie Curie, Paris, France.
Urolithiasis. 2018 Apr;46(2):129-136. doi: 10.1007/s00240-016-0898-1. Epub 2016 Jun 20.
Short-term ureteric stents are commonly placed after ureteroscopy. The removal usually entails having a cystoscopy, but recently, endourologists have been using stents with extraction strings attached to them for ease of removal. We wanted to conduct a systematic review of literature looking at the outcomes of ureteric stents with extraction strings attached to them. Our objective was to investigate the use, morbidity, tolerability, complications, associated cost, and patient preference of stents with extraction strings attached to them. All studies in English language (between 1990 and 2015) where stents on extraction strings were either self-removed by patients or removed by physician were included. A total of eight studies (1279 patients) were included, of which 483 (38 %) patients had extraction strings for removal. There seemed to be no overall difference in pain scores or urinary symptoms between patients with and without extraction strings, but nearly 10 % of patients suffered stent dislodgement in the group with extraction strings attached. Overall stent dwell time was lower in patients who had their stents removed via extraction strings, and majority of them were able to remove their stents at home. Our study suggests that stents with extraction strings are easy for patient self-removal and can reduce the stent dwell time for patients, thus reducing the duration of morbidity and physical and financial burden to patients. However, this must be balanced against a risk of stent dislodgement and, hence, may not be a good option in all patients.
短期输尿管支架通常在输尿管镜检查后放置。取出支架通常需要进行膀胱镜检查，但最近，腔内泌尿科医生已经开始使用带有取出线的支架，以方便取出。我们希望对文献进行系统综述，以了解带有取出线的输尿管支架的结果。我们的目的是调查带有取出线的支架的使用、发病率、耐受性、并发症、相关成本和患者偏好。所有纳入的研究均为英文文献（1990 年至 2015 年），其中支架通过患者自行或医生取出。共有 8 项研究（1279 例患者）纳入研究，其中 483 例（38%）患者采用取出线取出支架。带或不带取出线的患者之间疼痛评分或尿路症状似乎没有总体差异，但带取出线的患者中近 10%的患者出现支架移位。通过取出线取出支架的患者的支架留置时间更短，大多数患者可以在家中取出支架。我们的研究表明，带有取出线的支架便于患者自行取出，可以减少患者的支架留置时间，从而减少发病率、身体和经济负担的持续时间。然而，这必须与支架移位的风险相平衡，因此，对于所有患者来说，这可能不是一个好的选择。
