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Intravesical stent position as a predictor of quality of life in patients with indwelling ureteral stent

Inn FX, Ahmed N, Hou LG, Abidin ZAZ, Yi LL, Zainuddin ZM

Int Urol Nephrol, 2019 Nov;51(11):1949-1953.
PMID: 31441009 DOI: 10.1007/s11255-019-02262-7

PURPOSE: The internal drainage provided by a ureteral stent helps with the relief and prevention of ureteral obstruction. By definition, correct stent placement is one with a complete loop in both the renal pelvis and bladder. This prevents stent migration proximally or distally despite urinary flow, patient movement, and ureteral peristalsis.
METHODS: We performed a comparative prospective cross-sectional study assessing the impact of intravesical stent position on the quality of life in 46 patients with a ureteral stent. This is done using the Ureteral Stent Symptom Questionnaire (USSQ).
RESULTS: 52.5% of patients had an ipsilateral positioned intravesical stent, while the remaining had their stent positioned contralaterally. Intravesical stent position significantly influenced the quality of life. The USSQ score was worse for the contralateral group. Subscore analysis found that urinary symptoms and body pain index contribute significantly to the morbidity. Majority of patients in the ipsilateral group reported no discomfort as compared to the contralateral group.
CONCLUSIONS: To the best of our knowledge, this is the first study assessing the impact of intravesical stent position on the quality of life in the Asian population. Intravesical stent position has a significant influence on patient's morbidity and quality of life in particular towards their urinary irritative symptoms and body pain. It is imperative to ensure correct distal placement of ureteric stent that does not cross the midline to the contralateral site. We believe that the USSQ should be used in daily clinical practice in assessing the symptoms related to indwelling ureteric stents.

Matched MeSH terms: Ureteral Obstruction/surgery*
Sonographically guided removal of a double J ureteral stent in an infant

Jutti RC, Subramaniam R, Balsingh D, Qureshi AM

J Clin Ultrasound, 2002 May;30(4):232-5.
PMID: 11981933 DOI: 10.1002/jcu.10062

A 2-month-old male infant with a prenatally diagnosed obstruction of the ureteropelvic junction underwent a dismembered Anderson-Hynes pyeloplasty. A transanastomotic double J ureteral stent was placed between the renal pelvis and the urinary bladder. This report describes the subsequent removal of the double J ureteral stent from the patient's urinary bladder without the aid of a cystoscope: a rigid biopsy forceps was introduced trans-urethrally into the urinary bladder, and the stent was removed with sonographic guidance. Removal of a ureteral stent with sonographic guidance has not been previously reported in infants. This technique may be particularly useful in developing countries, where appropriate-sized cystoscopes and accessories may not be available.

Matched MeSH terms: Ureteral Obstruction/surgery*
Robotic-assisted laparoscopic ureteral reimplantation with psoas hitch: a multi-institutional, multinational evaluation

Patil NN, Mottrie A, Sundaram B, Patel VR

Urology, 2008 Jul;72(1):47-50; discussion 50.
PMID: 18384858 DOI: 10.1016/j.urology.2007.12.097

To report the collective experience of three multinational institutions with the use of robotics to evaluate and treat complex distal ureteral obstruction.

Matched MeSH terms: Ureteral Obstruction/surgery
Fulltext Total proximal ureter substitution using buccal mucosa

Fahmy O, Schubert T, Khairul-Asri MG, Stenzl A, Gakis G

Int J Urol, 2017 04;24(4):320-323.
PMID: 28208217 DOI: 10.1111/iju.13307

The surgical treatment of a long proximal ureteral stricture is a challenging situation for reconstructive surgeons. Despite the underlying morbidities, ileal interposition and autotransplantation are the options available to treat complex cases of long segment ureteral stricture. Buccal mucosa has shown excellent results in urethroplasty. However, its use in ureteral reconstruction is infrequent. We report on a 64-year-old female patient with multiple comorbidities and prior abdominal surgeries for Crohn's disease who underwent a successful total substitution of a long segment of the proximal ureter using buccal mucosa. Regular postoperative isotope scans showed improvement in renal function. Based on the pleasant outcome of this case and review of the literature, buccal mucosa might be a viable option with low morbidity in selected cases.

Matched MeSH terms: Ureteral Obstruction/surgery*