Percutaneous fluoroscopically guided removal of dysfunctioning ureteral stents.

PURPOSE

To present the authors' experience with fluoroscopically guided percutaneous removal of dysfunctioning ureteral stents and to discuss the technique and instrumentation used.

MATERIALS AND METHODS

Over 6 years, stent or stent fragment extraction procedures were performed in 20 patients. Indications included stent misplacement or migration, stent fracture, difficult retrograde exchange, stent occlusion, and removal prior to percutaneous ureteroscopy. Twelve extractions were performed as two-stage procedures and eight as one-stage procedures. A rigid forceps passed through a 12-F sheath was the preferred instrument for extraction. Other instruments used successfully included snares and flexible forceps.

RESULTS

Seventeen procedures were successful: Eight stents were removed with rigid forceps, seven with flexible forceps, and two with snares. Three procedures were unsuccessful: In two, the stent could not be grasped because there was intervening renal pelvic mucosa, and in one, clotted blood surrounded the stent. There were no undue complications.

CONCLUSION

This procedure is highly successful when appropriate technique and instruments are used.