Damodaran Vishal, Els Brandon, Daras Efthimia, Kataka Tracy, Gulamali Sadiyabanu Safiq, Ntakana S'babalwe, Perera Marlon, Adam Ahmed
The Unit for Undergraduate Medical Education (UUME), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Department of Surgery, University of Melbourne, Melbourne, VIC, Australia.
Curr Urol. 2023 Jun;17(2):92-99. doi: 10.1097/CU9.0000000000000104. Epub 2022 Aug 2.
Ureteral stents play a major role in maintaining ureteral patency. Various innovations are advocated in the design and subsequent removal of traditional double-J ureteral stents, such as the magnetic-end double-J ureteral stent (MEDJUS). This stent facilitates outpatient removal using a magnetic stent removal device. This systematic review was conducted to analyze the published role, efficacy, and outcomes of MEDJUS.
After PROSPERO registration (CRD42021235739), an electronic database search (PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science) was performed on December 31, 2020. The search terms were as follows: "," "" "," " ," and "."
Nine studies with a total of 685 patients were included in the systematic review. The total number of MEDJUS procedures used was 498 (73%) compared to the 187 (27%) traditional double-J stent method. Magnetic-end double-J ureteral stent extraction failure was reported in 8 cases (1.61%). Compared with traditional stents, MEDJUS showed a cost benefit in 5/5 studies. Better pain scores (during stent in situ) and (at stent removal) were observed in 2/3 and 3/4 of the studies, respectively.
Magnetic-end double-J ureteral stent may serve as a viable alternative to traditional double-J stents, offering cost and pain benefits with similar rates of complications. Magnetic-end double-J ureteral stent also offers relative ease of extraction and a reduced need for inpatient removal. This ambulatory stent removal technique has forged its use in modern urological practice.
输尿管支架在维持输尿管通畅方面发挥着重要作用。在传统双J型输尿管支架的设计及后续取出方面有多种创新方法,如磁性末端双J型输尿管支架(MEDJUS)。这种支架便于在门诊使用磁性支架取出装置取出。本系统评价旨在分析已发表的MEDJUS的作用、疗效及结果。
在PROSPERO注册(CRD42021235739)后,于2020年12月31日进行了电子数据库检索(PubMed、EMBASE、Cochrane图书馆、Scopus和Web of Science)。检索词如下:“……”“……”“……”“……”和“……”。
系统评价纳入了9项研究,共685例患者。与187例(27%)传统双J型支架方法相比,使用MEDJUS的手术总数为498例(73%)。有8例(1.61%)报告磁性末端双J型输尿管支架取出失败。与传统支架相比,在5项研究中的5项中MEDJUS显示出成本效益。分别在三分之二和四分之三的研究中观察到更好的疼痛评分(支架在位期间)和(支架取出时)。
磁性末端双J型输尿管支架可作为传统双J型支架的可行替代方案,在并发症发生率相似的情况下具有成本和疼痛优势。磁性末端双J型输尿管支架还具有取出相对容易且减少住院取出需求的特点。这种门诊支架取出技术已在现代泌尿外科实践中得到应用。