Ureteral expanding stent: a new device for urolithiasis.
OBJECTIVE
We investigate a ureteral stent with radially expanding baskets producing passive dilation of the ureter for passage, capture, and removal of small ureteral stones.


METHODS
Polyurethane ureteral stents were slit to open 15 to 17 baskets along the length. The baskets are designed to dilate the ureter passively and capture stones <or=5 mm. Forty-two patients had these stents placed for stones at nine medical centers. Stone size ranged from 2 to 30 mm, while fragment size ranged from 1 to 8 mm. The locations of the stones ranged from the kidney to the lower ureter. The Ureteral Expanding Stent was inserted in the closed position, similar to a standard ureteral stent, and left in place for an average of 11 days.


RESULTS
The device was inserted and extracted safely in all patients. Most patients experienced pain at an average rating of 3.7 of 10 on a visual analog scale. All stents were removed without significant morbidity. In 36 patients (86%), stones were removed with the stent (n=18) or passed while the stent was in place (n=18). The largest stone captured was 6 mm.


CONCLUSIONS
The Ureteral Expanding Stent (OPEN-Pass) was used safely in 42 patients with stones. The device captured ureteral stones and facilitated stone passage around it. Stent retention or ureteral injury as a result of stone entrapment did not occur. The Ureteral Expanding Stent represents a new stone-removal and ureteral-dilation tool worthy of further clinical study.
L'Esperance
James O
JO
Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
Rickner
Thomas
T
Hoenig
David
D
Bamberger
Mitchell
M
Albala
David M
DM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004106:Dilatation / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D011140:Polyurethanes; D011859:Radiography; D015607:Stents / Q000009:adverse effects; D014514:Ureteral Calculi / Q000000981:diagnostic imaging / Q000601:surgery*
D011140:Polyurethanes