S.H.KOH1, J.L.KWOK2, Y.Y.YEOW2, Y.M.LEE2
MOH Holdings Pte Ltd (MOHH)1, Tan Tock Seng Hospital2
Ureteric stents are inserted following ureteroscopy to mitigate symptoms such as clot or fragment colic and reduce the risk of ureteric obstruction. Removal usually entails having a cystoscopy or self-removal if stents with extraction strings are inserted. Despite evidence of similar complication rates and reduced healthcare costs for stents with extraction string, uptake of this practice remains poor.
We describe our technique of post-operatively converting stents with extraction string to one without. Stents with extraction string are usually left for up to a week. Reason for conversion could be due to presence of residual calculi, clot colic or concerns of ureteric obstruction. We first cut one arm of the double arm extraction string near the urethral meatus before pulling on the contralateral arm to remove the extraction string, leaving the stent in position.
X-ray performed a month later showed that the stent was still in position.
Over three-quarters of urologists place a ureteric stent following ureteroscopy. However, only less than a quarter use stents with extraction string. This may be due to concerns such as discomfort from string irritation and stent dislodgement. With our technique, stents with extraction strings can now be converted to string-less stents should we decide to after its insertion. This will hopefully improve the uptake of stents with extraction string and reduce healthcare cost burden.