Perez Alejandra, Nolte Adam Carl, Maurici Giuseppe, Small Alexander Charles, Liem Spencer Steve, Pereira Jorge Francisco, Polackwich Alan Scott, Yanes Rafael, Shah Ojas
Mount Sinai Medical Center, Department of Urology, 4302 Alton Road, MSOP Suite 540, Miami Beach, FL 33140, USA.
Olympus Medical Systems Corp., 4302 Alton Road, MSOP Suite 540, Miami Beach, FL 33140, USA.
Case Rep Urol. 2022 Feb 3;2022:5708348. doi: 10.1155/2022/5708348. eCollection 2022.
Retained ureteral stents can result in significant morbidity and can be surgically challenging to urologists. A multimodal approach is often necessary for removal, potentially including retrograde and antegrade procedures performed over multiple anesthetic sessions. We describe the novel "Tri-Glide" technique for treating retained stents, particularly those with stent shaft encrustation prohibiting safe removal. . Two patients with nephrolithiasis and retained, encrusted ureteral stents were managed with the "Tri-Glide" technique. Patient #1 was a 58-year-old man with a severely calcified ureteral stent, retained for 14 years. After undergoing simultaneous cystolitholapaxy and percutaneous nephrolithotomy to treat proximal and distal encrustations, the stent shaft remained trapped in the ureter due to heavy calcifications. Three hydrophilic guidewires were passed alongside the stent, allowing it to easily slide out of the ureter intact. Patient #2 was a 74-year-old man who after only 3-months of stent dwell time developed severe stent shaft encrustation preventing removal. After multiple maneuvers failed, the "Tri-Glide" technique was used to create a smooth track for stent to slide out intact with gentle traction. Both patients did well postoperatively with no complications.
The "Tri-Glide" technique can aid in the management of complex encrusted stent extractions, especially when there is significant shaft encrustation.
输尿管支架管残留可导致严重的发病率，并且对泌尿外科医生来说手术难度较大。取出通常需要采用多模式方法，可能包括在多次麻醉过程中进行逆行和顺行操作。我们描述了一种治疗残留支架管的新型“Tri-Glide”技术，特别是对于那些支架管轴结壳而无法安全取出的情况。两名患有肾结石和残留结壳输尿管支架管的患者采用“Tri-Glide”技术进行治疗。患者1是一名58岁男性，输尿管支架管严重钙化，已留置14年。在同时进行膀胱结石碎石术和经皮肾镜取石术以治疗近端和远端结壳后，由于严重钙化，支架管轴仍被困在输尿管中。三根亲水导丝与支架管并行通过，使其能够完整地轻松滑出输尿管。患者2是一名74岁男性，在支架管留置仅3个月后就出现了严重的支架管轴结壳，无法取出。在多次操作失败后，采用“Tri-Glide”技术为支架管创造了一条光滑的通道，通过轻柔牵引使其完整滑出。两名患者术后情况良好，无并发症。
“Tri-Glide”技术有助于处理复杂的结壳支架管取出，特别是当支架管轴有明显结壳时。
