Removal of retrievable self-expandable urethral stents: experience in 58 stents.
The purpose of this study was to retrospectively evaluate the safety and efficacy of removing retrievable self-expandable urethral stents using a retrieval hook wire. Under fluoroscopic guidance, the removal of 58 polyurethane or PTFE (polytetrafluoroethylene)-covered stents was attempted in 33 patients using a retrieval hook wire. Indications for removal were elective removal (n = 21), stent migration (n = 19), formation of tissue hyperplasia around or inside of the stent (n = 14), stent deformity (n = 3), and severe pain (n = 1). The mean time the stents remained in place was 64.8 +/- 42.9 days (range, 1-177 days). Fifty-six (97%) of the 58 stents were successfully removed using the retrieval hook wire despite the following difficulties; hook wire disconnection (n = 2), untied drawstrings (n = 3), and polyurethane membrane disruption/separation (n = 4). The removal procedure using a retrieval hook wire failed in two stents (3%) which had migrated into the urinary bladder. One of the two stents with migration into the urinary bladder was removed using a snare through the cystostomy route. The overall complication rate was 14% (seven hematuria cases and one urethral tear case), and all were minor and spontaneously resolved without further treatment. In conclusion, removal of retrievable urethral stents using a retrieval hook wire was safe and effective despite some technical difficulties. It is a useful method for allowing temporary stent placement and solving various complications of stent use.
Shin
Ji Hoon
JH
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1, Pungnap-2dong, Songpa-gu, Seoul, 138-736, South Korea.
Song
Ho-Young
HY
Park
Hyungkeun
H
Kim
Jin Hyoung
JH
Ko
Heung-Kyu
HK
Kim
Yong Jae
YJ
Woo
Chul-Woong
CW
Kim
Tae-Hyung
TH
Ko
Gi-Young
GY
Yoon
Hyun-Ki
HK
Sung
Kyu-Bo
KB
D000328:Adult; D000368:Aged; D020878:Device Removal / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D012189:Retrospective Studies; D012449:Safety; D015607:Stents / Q000009:adverse effects; D014521:Urethra / Q000000981:diagnostic imaging