O'Connell L, Broe M P, Rooney D, Elhag S, Cheema I, McGuire B B
Department of Urology, James Connolly Memorial Hospital Blanchardstown, Dublin 15, Ireland.
Ir Med J. 2018 Feb 9;111(2):687.
Ureteric stents are frequently inserted post endourological procedures. However, subsequent endoscopic stent removal requires a second procedure for the patient and the availability of necessary resources. Longer duration of indwelling stents can lead to increased risk of symptoms and complications. The use of magnetic stents removed with a magnetic retrieval device (BlackStar©), offers an alternative which obviates the need for cystoscopy. We assessed the outcomes for this novel method of stent removal in our institution. A retrospective analysis was performed of all patients undergoing magnetic stent insertion and subsequent removal in a nurse-led clinic over a nine-month period. Patients were followed up with a prospective validated Ureteral Stent Symptoms Questionnaire (USSQ)3. A cost analysis was also performed. In total, 59 patients were treated using magnetic stents. The complication rate was low (6.7%). The median duration of indwelling stent was 5.8 days (range 1-11 days). Patients reported haematuria and lower urinary tract symptoms but >90% experienced no functional impairment with minimal days of employment lost (mean 0.75 days). All patients reported satisfaction with nurse-led stent removal and 97% were happy to have stents removed via this method in the future. The total financial savings were estimated at €47,790 over this period. Nurse-led removal of magnetic stents is safe and well tolerated by patients and enables expedient stent removal. It also provides a significant cost benefit and frees up valuable endoscopic resources.
输尿管支架常在腔内泌尿外科手术后置入。然而,后续的内镜下支架取出术对患者来说需要进行二次手术,且需要有必要的资源。留置支架时间延长会导致症状和并发症风险增加。使用可通过磁性取出装置(BlackStar©)取出的磁性支架提供了一种无需膀胱镜检查的替代方法。我们评估了本院这种新型支架取出方法的效果。对在九个月期间由护士主导的诊所中所有接受磁性支架置入及后续取出的患者进行了回顾性分析。采用经过验证的前瞻性输尿管支架症状问卷(USSQ)3对患者进行随访。还进行了成本分析。共有59例患者使用了磁性支架。并发症发生率较低(6.7%)。留置支架的中位时间为5.8天(范围1 - 11天)。患者报告有血尿和下尿路症状,但超过90%的患者没有功能障碍,误工天数极少(平均0.75天)。所有患者对由护士主导的支架取出术表示满意,97%的患者愿意未来通过这种方法取出支架。在此期间,估计总共节省了47,790欧元。由护士主导取出磁性支架对患者来说是安全的且耐受性良好,能够方便快捷地取出支架。它还具有显著的成本效益,并且释放了宝贵的内镜资源。