Clinical evaluation of double-pigtail stent in patients with upper urinary tract diseases: report of 2685 cases.
OBJECTIVE
To review the indications, procedures, complications, and related treatments of double pigtail stent (DPS) placement as an adjunct for some types of endoscopic and open urologic surgery.


METHODS
From July 1998 to December 2006, 2413 patients aged 8 to 81 years underwent stent placement (2685 total placements). The indications consisted of ureteroscopic lithotripsy (1984 cases), percutaneous nephrolithotomy (329 cases), ureteral incision to remove calculi (71 cases), extracorporeal shockwave lithotripsy for upper urinary tract calculi (145 cases), ureteropelvic junction obstruction (31 cases), ureterocystoneostomy (29 cases), benign ureteral stenosis (52 cases), extrinsic ureteral stenosis (16 cases), and iatrogenic ureteral trauma (28 cases). DPSs were inserted into the ureter by cystoscopy (115 stents), ureteroscopy (2052 stents), percutaneous nephrostomy (393 stents), or open surgery (125 stents), and were kept inside the body for 28 +/- 1.7 days (range 1-193 days). The mean follow-up period was 31 +/- 1.9 days (range 1-123 days).


RESULTS
Three hundred sixty-five patients (19.6%) experienced one or more problems during the stenting procedure. The main complications were gross hematuria (385 cases), pain (101 cases), bladder irritation (105 cases), high fever (6 cases), encrustation (53 cases), stent migration (42 cases), and stenosis or restenosis (51 cases). Most of the complications were mild and tolerable, and all were immediately treated appropriately. However, 60 stents had to be removed: 29 for gross hematuria, 18 for pain, 7 for bladder irritation, and 6 for high fever.


CONCLUSIONS
DPS is a safe and useful adjunct for both endoscopic and open procedures to treat upper urinary tract diseases. Most of the complications of DPS placement can be well managed.
Hao
Ping
P
Oncological Center, Xinqiao Hospital, Third Military Medical University, Chongqing, People's Republic of China.
Li
Weibing
W
Song
Caiping
C
Yan
Junan
J
Song
Bo
B
Li
Longkun
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005548:Foreign-Body Migration; D006801:Humans; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous; D011859:Radiography; D015607:Stents / Q000009:adverse effects; D014513:Ureter / Q000000981:diagnostic imaging / Q000601:surgery; D014515:Ureteral Diseases / Q000628:therapy*; D018666:Ureteroscopy