Department of Urology, Singapore General Hospital, Singapore, Singapore.
Department of Urology, Ng Teng Feng General Hospital, Singapore, Singapore.
World J Urol. 2023 Nov;41(11):2889-2896. doi: 10.1007/s00345-023-04437-5. Epub 2023 May 27.
To assess the safety and effectiveness of magnetic ureteric stent removal with a special magnet retriever under ultrasound guidance.
A total of 60 male patients, who underwent ureteroscopy from October 2020 to March 2022, were prospectively enrolled and randomized into two groups. Group A patients underwent conventional double-J (DJ) stent insertion and subsequent stent removal via flexible cystoscopy. Group B patients underwent stent insertion using magnetic ureteric stent [Blackstar, Urotech (Achenmühle, Germany)] and stents were removed using a special magnet retriever under ultrasound guidance. Stents were left in situ for 30 days in both groups. All patients had follow-ups with a ureter stent symptoms questionnaire at 3- and 30-days post stent insertion. Visual analog scale (VAS) was assessed immediately after stent removal.
Stent removal time (142.5 s vs 142.5 s, group A vs group B, p < 0.0001) and VAS scores (4 vs 1, group A vs group B, p = 0.0008) were significantly lower in Group B. There were no statistically significant differences between both groups in the "urinary symptoms" (p = 0.3471) and "sexual matters" (p = 0.6126) in the USSQ domains. There was marginal statistical significance favoring Group A in the "body pain" (p = 0.0303), "general health score" (p = 0.0072), "additional problems" (p = 0.0142), and "work performance" (p < 0.0001) domains.
Magnetic ureteric stent can be considered as a safe and efficient alternative to conventional DJ stent. This approach avoids the need for cystoscopy, saving resources while minimizing patient discomfort.
评估在超声引导下使用特殊取石器取出磁性输尿管支架的安全性和有效性。
前瞻性纳入 2020 年 10 月至 2022 年 3 月期间接受输尿管镜检查的 60 例男性患者,并随机分为两组。A 组患者行常规双 J(DJ)支架置入,然后通过软性膀胱镜进行支架取出。B 组患者采用磁性输尿管支架(Blackstar,Urotech(德国 Achenmühle))置入,然后在超声引导下使用特殊取石器取出支架。两组患者均将支架原位保留 30 天。所有患者在支架置入后 3 天和 30 天进行输尿管支架症状问卷随访。支架取出后立即评估视觉模拟量表(VAS)评分。
B 组的支架取出时间(142.5 s 比 142.5 s,A 组比 B 组,p<0.0001)和 VAS 评分(4 分比 1 分,A 组比 B 组,p=0.0008)显著更低。USSQ 域中,两组间“尿症状”(p=0.3471)和“性问题”(p=0.6126)差异无统计学意义。在“身体疼痛”(p=0.0303)、“一般健康评分”(p=0.0072)、“附加问题”(p=0.0142)和“工作表现”(p<0.0001)域中,A 组具有统计学意义上的优势。
磁性输尿管支架可作为传统 DJ 支架的安全有效替代方法。这种方法避免了膀胱镜检查的需要,节省了资源,同时最大限度地减少了患者的不适。