Department of Urology, Salem Hospital, Academic Hospital, University of Heidelberg, Heidelberg, Germany.
J Endourol. 2024 Sep;38(9):969-976. doi: 10.1089/end.2024.0042. Epub 2024 Jun 5.
To assess the effectiveness and pain intensity associated with magnetic ureteral stent removal using a retriever, without the aid of ultrasound guidance. We prospectively enrolled 100 patients who underwent retrograde rigid and flexible ureterorenoscopy with or without laser lithotripsy for ureteronephrolithiasis treatment from September 2021 to June 2023. These patients were assigned in two groups. Group 1 underwent the traditional ureteral stent insertion, while Group 2 underwent magnetic ureteral stent insertion. Both insertion and removal times were documented. The indwelling time for ureteral stents was 14 days. One group underwent stent removal via flexible cystoscopy using grasping forceps and the other group using just a magnetic retriever, without the aid of ultrasound guidance. The numeric pain rating scale, recommendation rate, and a standardized self-answered ureter stent symptoms questionnaire (USSQ) were obtained directly after stent removal. Both groups presented comparable characteristics in factors such as age, body mass index, history of stone treatments, procedure type, and complication rates during and post-surgery. Time taken for ureteral stent insertion did not differ significantly between the groups (131.2 seconds for Group 1 159.1 seconds for Group 2). However, the stent removal time (152.1 seconds for Group 1 35.4 seconds for Group 2) and pain intensity (6 for Group 1 2 for Group 2) were significantly lower for Group 2. Furthermore, five out of the six sections of the USSQ showed significantly better results for Group 2. The use of magnetic ureteral stents, as a safe and efficient alternative to conventional ureteral stents, not only eliminates the need for cystoscopy but also conserves resources and reduces patient discomfort.
评估使用取石器在没有超声引导的情况下移除磁性输尿管支架的效果和疼痛强度。我们前瞻性地招募了 100 名患者,这些患者在 2021 年 9 月至 2023 年 6 月期间因输尿管结石病接受逆行硬性和软性输尿管镜检查,或同时接受激光碎石术治疗。这些患者被分为两组。第 1 组进行传统的输尿管支架置入,第 2 组进行磁性输尿管支架置入。记录支架置入和取出的时间。输尿管支架的留置时间为 14 天。一组通过软性膀胱镜检查使用抓钳取出支架,另一组仅使用磁性取石器取出支架,没有超声引导。在取出支架后直接获得数字疼痛评分、推荐率和标准化的自我回答输尿管支架症状问卷(USSQ)。两组在年龄、体重指数、结石治疗史、手术类型和围手术期并发症发生率等因素方面具有可比性。输尿管支架置入时间在两组之间无显著差异(第 1 组 131.2 秒,第 2 组 159.1 秒)。然而,支架取出时间(第 1 组 152.1 秒,第 2 组 35.4 秒)和疼痛强度(第 1 组 6 分,第 2 组 2 分)在第 2 组显著较低。此外,USSQ 的六个部分中有五个部分显示第 2 组的结果明显更好。使用磁性输尿管支架作为传统输尿管支架的安全有效的替代方案,不仅消除了膀胱镜检查的需要,还节省了资源并减轻了患者的不适。