Alternative Technique For Double J Stent Removal In Pediatric Patients: Case Series
DOI:
https://doi.org/10.34635/rpc.1021Keywords:
Surgical Technique, Pediatrics, Urology, double-JAbstract
Introduction: Double-J (DJ) ureteral stents are widely used in urological practice for the management of ureteral obstructions. As traditional techniques for ureteral stent removal, such as cystoscopy, may have limitations and associated risks, the development of more cost-effective alternative methods is relevant. In this study, we describe a novel technique for the removal of ureteral stents in three pediatric patients with the diagnosis of ureteropelvic junction (UPJ) stenosis.Case presentation: The surgical technique involves using a Nelaton urethral catheter with a polypropylene 3.0 wire attached. After bladder catheterization, the wire is fixed with two loops, and the bladder catheter is gently rotated and removed, enabling the extraction of the stent connected to the wire loop.
Discussion: The described technique was successfully employed in all cases. The surgical procedure was quick, easy to perform, and required minimal sedation. Although other cost-effective methods have been described, there is a lack of larger studies comparing these techniques.
Conclusions: Among the different modalities described, the decision regarding the best DJ removal procedure is still controversial and should be individualized, and further comparison between techniques is warranted.
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References
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2. Finney RP. Experience with New Double J Ureteral Catheter Stent. Journal of Urology. 1978;120(6):678–81.
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7. Gadzhiev N, Brovkin S, Grigoryev V, Dmitriev V, Korol V, Shkarupa D, et al. Ultrasound‐Guided Ureteral Stent Removal in Women. Journal of Ultrasound in Medicine. 2016;35(10):2159–63.
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9. Yadav R, Dalela D, Goyal N, Nagathan D, Sankhwar S. “Bilateral Double J Stent Removal: The way to do it!” Journal of Surgical Technique and Case Report. 2012;4(2):138.
10. Kajbafzadeh AM, Nabavizadeh B, Keihani S, Hosseini Sharifi SH. Revisiting the tethered ureteral stents in children: a novel modification. International Urology and Nephrology. 2015;47(6):881–5.
11. Sundaramurthy S, Joseph Thomas R, Herle K, Jeyaseelan, Mathai J, Jacob Kurian J. Double J stent removal in pediatric patients by Vellore Catheter Snare technique: a randomized control trial. Journal of Pediatric Urology. 2019;15(6):661.e1–8.
12. Yucel S, Samuelson ML, Nguyen MT, Baker LA. Usefulness of Short-Term Retrievable Ureteral Stent in Pediatric Laparoscopic Pyeloplasty. Journal of Urology. 2007;177(2):720–5.
13. Lai D, Chen M, Zha S, Wan S. A prospective and randomized comparison of rigid ureteroscopic to flexible cystoscopic retrieval of ureteral stents. BMC Urology. 2017;17(1).
14. Hadley DA, Wicher C, Wallis MC. Retrograde Percutaneous Access for Kidney Internal Splint Stent Catheter Placement in Pediatric Laparoscopic Pyeloplasty: Avoiding Stent Removal in the Operating Room. Journal of Endourology. 2009;23(12):1991–4.
15. Söylemez H, Sancaktutar AA, Bozkurt Y, Atar M, Penbegül N, Yildirim K. A Cheap Minimally Painful and Widely Usable Alternative for Retrieving Ureteral Stents. Urologia Internationalis. 2011;87(2):199–204.
16. Ozturk H. Facilitate Stent Removal: Magnetic DJ Stent. Urology Case Reports. 2017;11:55–6.
17. Lin H, Xu M, Jiang D, Xu G, Fang X, Jia J, et al. Non-cystoscopic Removal of Retained Ureteral Stents With Mild Sedation in Children. Urology. 2016;94:255–8.
18. Kawahara T, Ito H, Terao H, et al. Ureteral stent retrieval using the crochet hook technique in females. PLoS One 2012; 7:e29292.
19. Piçarro C, Silva JMP, Oliveira EA. Hydronephrosis in children. Revista Médica de Minas Gerais. 2014;24.
20. Marques JM, Gomes AC da SF, Oliveira JTM de, Marques GM, Schräder J da R, Pereira BS da S, et al. Estenose de junção ureteropélvica: Um relato de caso/Ureteropelvic junction stenosis: A case report. Brazilian Journal of Health Review. 2021;4(6):25754–64.
21. Carlstrom M. Hydronephrosis and Risk of Later Development of Hypertension. Acta Paediatr. 2019; 108: 50–57.
2. Finney RP. Experience with New Double J Ureteral Catheter Stent. Journal of Urology. 1978;120(6):678–81.
3. Fiuk J, Bao Y, Calleary JG, Schwartz BF, Denstedt JD. The use of internal stents in chronic ureteral obstruction. The Journal of Urology. 2015;193(4):1092–100.
4. Nunes TF, Tibana TK, Santos RFT, Carramanho Junior J da C, Marchiori E. Percutaneous insertion of bilateral double J stent. Radiologia Brasileira. 2019;52(2):104–5.
5. Nunes TF, Tibana TK, Santos RFT, Inchingolo R. Modified technique for double J stent removal. Radiologia Brasileira. 2021;54(3):204–5.
6. Kim ET, Yang WJ, Shin JH, Wang YH, Narcise L. Clinical Utility of the Modified Snare Technique for Percutaneous Antegrade Removal of Double J Ureteral Stents. Journal of Vascular and Interventional Radiology. 2020;31(1):155–61.
7. Gadzhiev N, Brovkin S, Grigoryev V, Dmitriev V, Korol V, Shkarupa D, et al. Ultrasound‐Guided Ureteral Stent Removal in Women. Journal of Ultrasound in Medicine. 2016;35(10):2159–63.
8. Muniz WQ, Queiroz EJC, Santos ACV, Lima JTS, Estumano JC, Patrício D da S, et al. Desfecho Clínico-cirúrgico da permanência equivocada de cateter duplo J: um relato de caso. Brazilian Journal of Health Review. 2020;3(3):4638–49.
9. Yadav R, Dalela D, Goyal N, Nagathan D, Sankhwar S. “Bilateral Double J Stent Removal: The way to do it!” Journal of Surgical Technique and Case Report. 2012;4(2):138.
10. Kajbafzadeh AM, Nabavizadeh B, Keihani S, Hosseini Sharifi SH. Revisiting the tethered ureteral stents in children: a novel modification. International Urology and Nephrology. 2015;47(6):881–5.
11. Sundaramurthy S, Joseph Thomas R, Herle K, Jeyaseelan, Mathai J, Jacob Kurian J. Double J stent removal in pediatric patients by Vellore Catheter Snare technique: a randomized control trial. Journal of Pediatric Urology. 2019;15(6):661.e1–8.
12. Yucel S, Samuelson ML, Nguyen MT, Baker LA. Usefulness of Short-Term Retrievable Ureteral Stent in Pediatric Laparoscopic Pyeloplasty. Journal of Urology. 2007;177(2):720–5.
13. Lai D, Chen M, Zha S, Wan S. A prospective and randomized comparison of rigid ureteroscopic to flexible cystoscopic retrieval of ureteral stents. BMC Urology. 2017;17(1).
14. Hadley DA, Wicher C, Wallis MC. Retrograde Percutaneous Access for Kidney Internal Splint Stent Catheter Placement in Pediatric Laparoscopic Pyeloplasty: Avoiding Stent Removal in the Operating Room. Journal of Endourology. 2009;23(12):1991–4.
15. Söylemez H, Sancaktutar AA, Bozkurt Y, Atar M, Penbegül N, Yildirim K. A Cheap Minimally Painful and Widely Usable Alternative for Retrieving Ureteral Stents. Urologia Internationalis. 2011;87(2):199–204.
16. Ozturk H. Facilitate Stent Removal: Magnetic DJ Stent. Urology Case Reports. 2017;11:55–6.
17. Lin H, Xu M, Jiang D, Xu G, Fang X, Jia J, et al. Non-cystoscopic Removal of Retained Ureteral Stents With Mild Sedation in Children. Urology. 2016;94:255–8.
18. Kawahara T, Ito H, Terao H, et al. Ureteral stent retrieval using the crochet hook technique in females. PLoS One 2012; 7:e29292.
19. Piçarro C, Silva JMP, Oliveira EA. Hydronephrosis in children. Revista Médica de Minas Gerais. 2014;24.
20. Marques JM, Gomes AC da SF, Oliveira JTM de, Marques GM, Schräder J da R, Pereira BS da S, et al. Estenose de junção ureteropélvica: Um relato de caso/Ureteropelvic junction stenosis: A case report. Brazilian Journal of Health Review. 2021;4(6):25754–64.
21. Carlstrom M. Hydronephrosis and Risk of Later Development of Hypertension. Acta Paediatr. 2019; 108: 50–57.
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Published
2024-07-29
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