Placement of double-J ureteric stent using the pull-through technique in patients with tight ureteric stenosis.
BACKGROUND
To evaluate the efficacy of antegrade insertion of the ureteric stent using pull-through technique in tight ureteric stricture that a guide-wire traversed, but a 5-F catheter could not.


METHODS
Seven patients (M:F = 2:5, mean age 56 years) who underwent antegrade ureteric stent insertion using pull-through technique due to tight ureteric stricture were retrospectively evaluated. The strictures were due to impacted ureter stone (n = 3), metastasis from rectal cancer (n = 1), and idiopathic ureter stricture (n = 3). After failing to traverse a 5-F catheter through the stricture along the guide-wire, a 7-F introducer sheath was inserted through the urethra. The distal end of the guide-wire was snared and retrieved through the urethral introducer sheath. Then using pull-through technique, antegrade ureteric stent insertion was performed.


RESULTS
Double-J ureteric stent was successfully placed in all seven patients using the pull-through technique. Complications included abdominal/flank pain (n = 7), gross hematuria (n = 5) and elevated blood pressure (n = 1). All complications were relieved within 3 days after the procedure with conservative treatment.


CONCLUSIONS
Antegrade double-J ureteric stent insertion using the pull-through technique is a safe and useful method, which can be used in tight ureteric strictures, where a ureteric stent cannot follow the passed guide wire.
Kim
Byung Moon
BM
Department of Diagnostic Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, Republic of Korea. bmoon21@hanmail.net
Park
Sung Il
SI
D000328:Adult; D000368:Aged; D003251:Constriction, Pathologic / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D012004:Rectal Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D014514:Ureteral Calculi / Q000150:complications; D014516:Ureteral Neoplasms / Q000150:complications* / Q000556:secondary; D014517:Ureteral Obstruction / Q000209:etiology / Q000601:surgery*