Abstract
Ureteral access is necessary in many endourological procedures including ureteroscopy and ureteral stenting. Technologies such as ureteral access sheaths, balloon dilators, and coaxial dilators may be helpful in facilitating ureteral access in difficult cases. This chapter describes a stenting technique that relies on fluoroscopic guidance once the initial guidewire is placed and the cystoscope is removed.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Camunez F, Echenagusia A, Prieto ML, Salom P, Herranz F, Hernandez C. Percutaneous nephrostomy in pyonephrosis. Urol Radiol 1989; 11(2): 77–81.
Pearle MS, Pierce HL, Miller GL, et al. Optimal method of urgent decompression of the collecting system for obstruction and infection due to ureteral calculi. J Urol 1998; 160(4): 1260–1264.
Mokhmalji H, Braun PM, Martinez Portillo FJ, Siegsmund M, Alken P, Kohrmann KU. Percutaneous nephrostomy versus ureteral stents for diversion of hydronephrosis caused by stones: a prospective, randomized clinical trial. J Urol 2001; 165(4): 1088–1092.
Lennon GM, Thornhill JA, Grainger R, McDermott TE, Butler MR. Double pigtail ureteric stent versus percutaneous nephrostomy: effects on stone transit and ureteric motility. Eur Urol 1997; 31(1): 24–29.
Leventhal EK, Rozanski TA, Crain TW, Deshon GE, Jr. Indwelling ureteral stents as definitive therapy for distal ureteral calculi. J Urol 1995; 153(1): 34–36.
Joshi HB, Okeke A, Newns N, Keeley FX, Jr., Timoney AG. Characterization of urinary symptoms in patients with ureteral stents. Urology 2002; 59(4): 511–516.
Joshi HB, Stainthorpe A, MacDonagh RP, Keeley FX, Jr., Timoney AG, Barry MJ. Indwelling ureteral stents: evaluation of symptoms, quality of life and utility. J Urol 2003; 169(3): 1065–1069.
Joshi HB, Newns N, Stainthorpe A, MacDonagh RP, Keeley FX, Jr., Timoney AG. Ureteral stent symptom questionnaire: development and validation of a multidimensional quality of life measure. J Urol 2003; 169(3): 1060–1064.
Pryor JL, Jenkins AD. Use of double-pigtail stents in extracorporeal shock wave lithotripsy. J Urol 1990; 143(3): 475–478.
Ryan PC, Lennon GM, McLean PA, Fitzpatrick JM. The effects of acute and chronic JJ stent placement on upper urinary tract motility and calculus transit. Br J Urol 1994; 74(4): 434–439.
Sayed MA, el Taher AM, Aboul-Ella HA, Shaker SE. Steinstrasse after extracorporeal shockwave lithotripsy: aetiology, prevention and management. BJU Int 2001; 88(7): 675–678.
Fedullo LM, Pollack HM, Banner MP, Amendola MA, Van Arsdalen KN. The development of steinstrassen after ESWL: frequency, natural history, and radiologic management. AJR Am J Roentgenol 1988; 151(6): 1145–1147.
Libby JM, Meacham RB, Griffith DP. The role of silicone ureteral stents in extracorporeal shock wave lithotripsy of large renal calculi. J Urol 1988; 139(1): 15–17.
Al Awadi KA, Abdul HH, Kehinde EO, Al Tawheed A. Steinstrasse: a comparison of incidence with and without J stenting and the effect of J stenting on subsequent management. BJU Int 1999; 84(6): 618–621.
Sulaiman MN, Buchholz NP, Clark PB. The role of ureteral stent placement in the prevention of Steinstrasse. J Endourol 1999; 13(3): 151–155.
Sheir KZ, Madbouly K, Elsobky E. Prospective randomized comparative study of the effectiveness and safety of electrohydraulic and electromagnetic extracorporeal shock wave lithotriptors. J Urol 2003; 170(2 Pt 1): 389–392.
Preminger GM, Kettelhut MC, Elkins SL, Seger J, Fetner CD. Ureteral stenting during extracorporeal shock wave lithotripsy: help or hindrance? J Urol 1989; 142(1): 32–36.
Bierkens AF, Hendrikx AJ, Lemmens WA, Debruyne FM. Extracorporeal shock wave lithotripsy for large renal calculi: the role of ureteral stents. A randomized trial. J Urol 1991; 145(4): 699–702.
Kirkali Z, Esen AA, Akan G. Place of double-J stents in extracorporeal shock wave lithotripsy. Eur Urol 1993; 23(4): 460–462.
Chandhoke PS, Barqawi AZ, Wernecke C, Chee-Awai RA. A randomized outcomes trial of ureteral stents for extracorporeal shock wave lithotripsy of solitary kidney or proximal ureteral stones. J Urol 2002; 167(5): 1981–1983.
Madbouly K, Sheir KZ, Elsobky E, Eraky I, Kenawy M. Risk factors for the formation of a steinstrasse after extracorporeal shock wave lithotripsy: a statistical model. J Urol 2002; 167(3): 1239–1242.
Eisenberger F, Rassweiler J. Stone Therapy in Urology. Thieme Medical Publisher, New York, 1991: 29.
Hosking DH, McColm SE, Smith WE. Is stenting following ureteroscopy for removal of distal ureteral calculi necessary? J Urol 1999; 161(1): 48–50.
Denstedt JD, Wollin TA, Sofer M, Nott L, Weir M, Honey D’Art. Aprospective randomized controlled trial comparing nonstented versus stented ureteroscopic lithotripsy. J Urol 2001; 165(5): 1419–1422.
Wollin TA, Denstedt JD. The holmium laser in urology. J Clin Laser Med Surg 1998; 16(1): 13–20.
Chen YT, Chen J, Wong WY, Yang SS, Hsieh CH, Wang CC. Is ureteral stenting necessary after uncomplicated ureteroscopic lithotripsy? A prospective, randomized controlled trial. J Urol 2002; 167(5): 1977–1980.
Hollenbeck BK, Schuster TG, Faerber GJ, Wolf JS, Jr. Routine placement of ureteral stents is unnecessary after ureteroscopy for urinary calculi. Urology 2001; 57(4): 639–643.
Byrne RR, Auge BK, Kourambas J, Munver R, Delvecchio F, Preminger GM. Routine ureteral stenting is not necessary after ureteroscopy and ureteropyeloscopy: a randomized trial. J Endourol 2002; 16(1): 9–13.
Borboroglu PG, Amling CL, Schenkman NS, et al. Ureteral stenting after ureteroscopy for distal ureteral calculi: a multi-institutional prospective randomized controlled study assessing pain, outcomes and complications. J Urol 2001; 166(5): 1651–1657.
Netto NR, Jr., Ikonomidis J, Zillo C. Routine ureteral stenting after ureteroscopy for ureteral lithiasis: is it really necessary? J Urol 2001; 166(4): 1252–1254.
Puskar D, Balagovic I, Filipovic A, et al. Symptomatic physiologic hydronephrosis in pregnancy: incidence, complications and treatment. Eur Urol 2001; 39(3): 260–263.
Zwergel T, Lindenmeir T, Wullich B. Management of acute hydronephrosis in pregnancy by ureteral stenting. Eur Urol 1996; 29(3): 292–297.
Fainaru O, Almog B, Gamzu R, Lessing JB, Kupferminc M. The management of symptomatic hydronephrosis in pregnancy. BJOG: 2002; 109(12): 1385–1387.
Wolf MC, Hollander JB, Salisz JA, Kearney DJ. A new technique for ureteral stent placement during pregnancy using endoluminal ultrasound. Surg Gynecol Obstet 1992; 175(6): 575–576.
Fabrizio MD, Gray DS, Feld RI, Bagley DH. Placement of ureteral stents in pregnancy using ultrasound guidance. Tech Urol 1996; 2(3): 121–125.
Sahin H, Bircan MK, Yayla M. JJS application in acute symptomatic hydronephrosis in pregnancy. BJOG 1997; 59(2): 141–142.
Delakas D, Karyotis I, Loumbakis P, Daskalopoulos G, Kazanis J, Cranidis A. Ureteral drainage by double-J-catheters during pregnancy. Clin Exp Obstet Gynecol 2000; 27(3–4): 200–202.
Hellawell GO, Cowan NC, Holt SJ, Mutch SJ. A radiation perspective for treating loin pain in pregnancy by double-pigtail stents. BJU Int 2002; 90(9): 801–808.
Watterson JD, Girvan AR, Beiko DT, et al. Ureteroscopy and holmium:YAG laser lithotripsy: an emerging definitive management strategy for symptomatic ureteral calculi in pregnancy. Urology 2002; 60(3): 383–387.
Roy SC, Sandison GA. Shielding for neutron scattered dose to the fetus in patients treated with 18 MV X-ray beams. Med Phys 2000; 27(8): 1800–1803.
Gorton E, Whitfield HN. Renal calculi in pregnancy. Br J Urol 1997; 80(Suppl 1): 4–9.
Rodriguez PN, Klein AS. Management of urolithiasis during pregnancy. Surg Gynecol Obstet 1988; 166(2): 103–106.
Hendricks SK, Ross SO, Krieger JN. An algorithm for diagnosis and therapy of management and complications of urolithiasis during pregnancy. Surg, Gynecol Obstet 1991; 172(1): 49–54.
Stothers L, Lee LM. Renal colic in pregnancy. J Urol 1992; 148(5): 1383–1387.
Evans HJ, Wollin TA. The management of urinary calculi in pregnancy. Curr Opin Urol 2001; 11(4): 379–384.
Goldfarb RA, Neerhut GJ, Lederer E. Management of acute hydronephrosis of pregnancy by ureteral stenting: risk of stone formation. J Urol 1989; 141(4): 921–922.
Denstedt JD, Razvi H. Management of urinary calculi during pregnancy. J Urol 1992; 148(3 Pt 2): 1072–1074.
Kavoussi LR, Albala DM, Basler JW, Apte S, Clayman RV. Percutaneous management of urolithiasis during pregnancy. J Urol 1992; 148(3 Pt 2): 1069–1071.
Razvi HA, Denstedt JD. Endoscopic management of ureteral injury after cesarean section. J Endourol 1994; 8(5): 345–347.
Lifshitz DA, Lingeman JE. Ureteroscopy as a first-line intervention for ureteral calculi in pregnancy. J Endourol 2002; 16(1): 19–22.
Watterson JD, Girvan AR, Beiko DT, et al. Ureteroscopy and holmium:YAG laser lithotripsy: an emerging definitive management strategy for symptomatic ureteral calculi in pregnancy. Urology 2002; 60(3): 383–387.
Wickham JE, Kellet MJ. Percutaneous pyelolysis. Eur Urol 1983; 9(2): 122–124.
Danuser H, Hochreiter WW, Ackermann DK, Studer UE. Influence of stent size on the success of antegrade endopyelotomy for primary ureteropelvic junction obstruction: results of 2 consecutive series. J Urol 2001; 166(3): 902–909.
Moon YT, Kerbl K, Pearle MS, et al. Evaluation of optimal stent size after endourologic incision of ureteral strictures. J Endourol 1995; 9(1): 15–22.
Anidjar M, Meria P, Cochand-Priollet B, et al. Evaluation of optimal stent size after antegrade endopyelotomy: an experimental study in the porcine model. Eur Urol 1997; 32(2): 245–252.
Kumar R, Kapoor R, Mandhani A, Kumar A, Ahlawat R. Optimum duration of splinting after endopyelotomy. J Endourol 1999; 13(2): 89–92.
Mandhani A, Kapoor R, Zaman W, Kumar A, Bhandari M, Gambhir S. Is a 2-weeks duration sufficient for stenting in endopyelotomy? J Urol 2003; 169(3): 886–889.
Kerbl K, Chandhoke PS, Figenshau RS, Stone AM, Clayman RV. Effect of stent duration on ureteral healing following endoureterotomy in an animal model. J Urol 1993; 150(4): 1302–1305.
Park DS, Park JH, Lee YT. Percutaneous nephrostomy versus indwelling ureteral stents in patients with bilateral nongenitourinary malignant extrinsic obstruction. J Endourol 2002; 16(3): 153–154.
Chye RW, Lickiss JN. Palliative care in bilateral malignant ureteric obstruction. Ann Acad Med Singapore 1994; 23(2): 197–203.
Emmert C, Rassler J, Kohler U. Survival and quality of life after percutaneous nephrostomy for malignant ureteric obstruction in patients with terminal cervical cancer. Arch Gynecol Obstet 1997; 259(3): 147–151.
Pappas P, Stravodimos KG, Mitropoulos D, et al. Role of percutaneous urinary diversion in malignant and benign obstructive uropathy. J Endourol 2000; 14(5): 401–405.
Kinn AC, Lykkeskov-Andersen H. Impact on ureteral peristalsis in a stented ureter. An experimental study in the pig. Urol Res 2002; 30(4): 213–218.
Yossepowitch O, Lifshitz DA, Dekel Y, et al. Predicting the success of retrograde stenting for managing ureteral obstruction. J Urol 2001; 166(5): 1746–1749.
Jabbour ME, Desgrandchamps F, Angelescu E, Teillac P, Le Duc A. Percutaneous implantation of subcutaneous prosthetic ureters: long-term outcome. J Endourol 2001; 15(6): 611–614.
Minhas S, Irving HC, Lloyd SN, Eardley I, Browning AJ, Joyce AD. Extra-anatomic stents in ureteric obstruction: experience and complications. BJU Int 1999; 84(7): 762–764.
Nissenkorn I, Gdor Y. Nephrovesical subcutaneous stent: an alternative to permanent nephrostomy. J Urol 2000; 163(2): 528–530.
Barbalias GA, Liatsikos EN, Kalogeropoulou C, Karnabatidis D, Siablis D. Metallic stents in gynecologic cancer: an approach to treat extrinsic ureteral obstruction. Eur Urol 2000; 38(1): 35–40.
Hekimoglu B, Men S, Pinar A, I et al. Urothelial hyperplasia complicating use of metal stents in malignant ureteral obstruction. Eur Radiol 1996; 6(5): 675–681.
Lopez-Martinez RA, Singireddy S, Lang EK. The use of metallic stents to bypass ureteral strictures secondary to metastatic prostate cancer: experience with 8 patients. J Urol 1997; 158(1): 50–53.
Pauer W, Lugmayr H. Metallic Wallstents: a new therapy for extrinsic ureteral obstruction. J Urol 1992; 148(2 Pt 1): 281–284.
Little B, Ho KJ, Gawley S, Young M. Use of nephrostomy tubes in ureteric obstruction from incurable malignancy. Int J Clin Pract 2003; 57(3): 180–181.
Gotman I. Characteristics of metals used in implants. J Endourol 1997; 11(6): 383–389.
Kumar PV, Keeley FX, Timoney AG. Safe flexible ureterorenoscopy with a dual-lumen access catheter and a safety guidewire. BJU Int 2001; 88(6): 638–639.
Monga M, Bhayani S, Landman J, Conradie M, Sundaram CP, Clayman RV. Ureteral access for upper urinary tract disease: the access sheath. J Endourol 2001; 15(8): 831–834.
Stoller ML, Wolf JS, Jr., Hofmann R, Marc B. Ureteroscopy without routine balloon dilation: an outcome assessment. J Urol 1992; 147(5): 1238–1242.
Rodrigues NN, Jr., Caserta LG, Levi D’Ancona CA, Ikari O, Ferreira U, Francisco de Almeida CJ. Is routine dilation of the ureter necessary for ureteroscopy? Eur Urol 1990; 17(4): 269–272.
Boddy SA, Nimmon CC, Jones S, et al. Acute ureteric dilatation for ureteroscopy. An experimental study. Br J Urol 1988; 61(1): 27–31.
Lennon GM, Fitzpatrick JM. Effects of balloon dilatation on canine ureteric physiology. Eur Urol 1994; 25(3): 248–253.
Begin LR, Selmy GI, Hassouna MM, Khalaf IM, Elhilali MM. Healing and muscular restoration of the ureteral wall following balloon-induced rupture: an experimental animal model with light microscopic and ultrastructural observations. Experimental & Molecular Pathology 1993; 59(1): 58–70.
Ford TF, Parkinson MC, Wickham JE. Clinical and experimental evaluation of ureteric dilatation. Br J Urol 1984; 56(5): 460–463.
Huffman JL, Bagley DH. Balloon dilation of the ureter for ureteroscopy. J Urol 1988; 140(5): 954–956.
Gaylis F, Bastuba M, Bidair M, Friedel W. Ureteral dilation using a tapered dilator: a cost-effective approach. J Endourol 2000; 14(5): 447–449.
Takayasu H, Aso Y. Recent development for pyeloureteroscopy: guide tube method for its introduction into the ureter. J Urol 1974; 112(2): 176–178.
Rich M, Lee WJ, Smith AD. Applications of the peel-away introducer sheath. J Urol 1987; 137(3): 452–454.
Kourambas J, Byrne RR, Preminger GM. Does a ureteral access sheath facilitate ureteroscopy? J Urol 2001; 165(3): 789–793.
Wu NZ, Auge BK, Preminger GM. Simplified ureteral stent placement with the assistance of a ureteral access sheath. J Urol 2001; 166(1): 206–208.
Pietrow PK, Auge BK, Delvecchio FC, et al. Techniques to maximize flexible ureteroscope longevity. Urology 2002; 60(5): 784–788.
Delvecchio FC, Auge BK, Brizuela RM, et al. Assessment of structure formation with the ureteral access sheath. Urology 2003; 61: 518–522.
Chin JL, Denstedt JD. Retrieval of proximally migrated ureteral stents. J Urol 1992; 148(4): 1205–1206.
Ilgit ET, Akpek S, Isik S. Repositioning of a misplaced ureteral stent with a balloon catheter: technical note. Eur J Radiol 1997; 24(3): 257–259.
Ko W, Lee W, Jung J, Lee M. Spontaneous proximal double pigtail ureteral stent migration after shock wave lithotripsy: “jack” phenomenon. J Urol 2001; 166(4): 1387.
Maheshwari PN, Choudhri S, Parmar VP. Re: Optimal prevention and management of proximal ureteral stent migration and remigration. J Urol 2002; 168(1): 202.
Denstedt JD, Wollin TA, Reid G. Biomaterials used in urology: current issues of biocompatibility, infection, and encrustation. J Endourol 1998; 12(6): 493–500.
Denstedt JD, Reid G, Sofer M. Advances in ureteral stent technology. World J Urol 2000; 18(4): 237–242.
Lingeman JE, Preminger GM, Berger Y, et al. Use of a temporary ureteral drainage stent after uncomplicated ureteroscopy: results from a phase II clinical trial. J Urol 2003; 169(5): 1682–1688.
Beiko DT, Knudsen BE, Denstedt JD. Advances in ureteral stent design. J Endourol 2003; 17(4): 195–199.
Beiko DT, Knudsen BE, Watterson JD, Denstedt JD. Biomaterials in urology. Curr Urol Rep 2003; 4(1): 51–55.
Kehinde EO, Rotimi VO, Al Awadi KA, et al. Factors predisposing to urinary tract infection after J ureteral stent insertion. J Urol 2002; 167(3): 1334–1337.
Reid G, Habash M, Vachon D, Denstedt J, Riddell J, Beheshti M. Oral fluoroquinolone therapy results in drug adsorption on ureteral stents and prevention of biofilm formation. Int J Antimicrob Agents 2001; 17(4): 317–319.
Paick SH, Park HK, Oh SJ, Kim HH. Characteristics of bacterial colonization and urinary tract infection after indwelling of double-J ureteral stent. Urology 2003; 62(2): 214–217.
Lingeman JE, Schulsinger DA, Kuo RL. Phase I trial of a temporary ureteral drainage stent. J Endourol 2003; 17(3): 169–171.
Watterson JD, Cadieux PA, Beiko DT, et al. Oxalate-degrading enzymes from Oxalobacter formigenes: a novel device coating to reduce urinary tract biomaterial-related encrustation. J Endourol 2003; 17(5): 269–274.
Multanen M, Talja M, Hallanvuo S, et al. Bacterial adherence to silver nitrate coated poly-L-lactic acid urological stents in vitro. Urol Res 2000; 28(5): 327–331.
Beiko DT, Watterson JD, Knudsen BE, et al. A double-blinded prospective randomized controlled trial assessing the safety and efficacy of intravesical agents for ureteral stent symptoms following extracorporeal shockwave lithotripsy. J Endourol 2004; 18(8): 723–730.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2006 Humana Press Inc., Totowa, NJ
About this chapter
Cite this chapter
Chew, B.H., Denstedt, J.D. (2006). Access, Stents, and Urinary Drainage. In: Nakada, S.Y., Pearle, M.S. (eds) Advanced Endourology. Current Clinical Urology. Humana Press. https://doi.org/10.1007/978-1-59259-954-7_2
Download citation
DOI: https://doi.org/10.1007/978-1-59259-954-7_2
Publisher Name: Humana Press
Print ISBN: 978-1-58829-446-3
Online ISBN: 978-1-59259-954-7
eBook Packages: MedicineMedicine (R0)