title: Fluoroscopic guidance of retrograde exchange of ureteral stents in women.
abstract: OBJECTIVE
  The purpose of this study was to review our experience with fluoroscopically guided retrograde exchange of ureteral stents in women.
  
  
  METHODS
  During a 48-month period, 28 women (age range, 38-76 years) were referred to our department for retrograde exchange of a ureteral stent. The causes of urinary obstruction were tumor compression in 26 patients and benign fibrotic stricture in two patients. A large-diameter snare catheter (25-mm single loop or 18- to 35-mm triple loop) or a foreign body retrieval forceps (opening width, 11.3 mm) was used to grasp the bladder end of the stent under fluoroscopic guidance. The technique entailed replacement of a patent or occluded ureteral stent with a 0.035- or 0.018-inch guidewire with or without the aid of advancement of an angiographic sheath.
  
  
  RESULTS
  A total of 54 ureteral stents were exchanged with a snare catheter in 42 cases or a forceps in 12 cases. One stent misplaced too far up the ureter was replaced successfully through antegrade percutaneous nephrostomy. Ten occluded stents, including one single-J stent, were managed with a 0.018-inch guidewire in three cases, advancement of an angiographic sheath over the occluded stent into the ureter in five cases, and recannulation of the ureteral orifice with a guidewire in two cases. No complications of massive hemorrhage, ureter perforation, or infection were encountered.
  
  
  CONCLUSIONS
  With proper selection of a snare or forceps catheter, retrograde exchange of ureteral stents in women can be easily performed under fluoroscopic guidance with high technical success and a low complication rate.
authors.affiliation: Department of Radiology, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd., Kaohsiung, Taiwan, Republic of China.
authors.forename: Ruey-Sheng
authors.initials: RS
authors.lastname: Chang
authors.forename: Huei-Lung
authors.initials: HL
authors.lastname: Liang
authors.forename: Jer-Shyung
authors.initials: JS
authors.lastname: Huang
authors.forename: Po-Chin
authors.initials: PC
authors.lastname: Wang
authors.forename: Matt Chiung-Yu
authors.initials: MC
authors.lastname: Chen
authors.forename: Ping-Hong
authors.initials: PH
authors.lastname: Lai
authors.forename: Huay-Ben
authors.initials: HB
authors.lastname: Pan
mesh_terms: D000328:Adult; D000368:Aged; D020878:Device Removal / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000379:methods*; D015607:Stents; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D014513:Ureter / Q000000981:diagnostic imaging* / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*