title: Fluoro-less ureteral stent placement following uncomplicated ureteroscopic stone removal: a feasibility study.
abstract: OBJECTIVE
  To test the feasibility of ureteral stent placement without image guidance after uncomplicated ureteral stone removal and to compare the outcomes of fluoro-less and conventional ureteral stent placement.
  
  
  METHODS
  A technique was devised to allow placement of a ureteral stent without image guidance by substituting fluoroscopy with visual and tactile cues. A retrospective review of 25 patients using fluoro-less stent placement was compared with 25 consecutive patients who underwent conventional stent placement with fluoroscopy. Stent placement was graded on a 6-point scale to assess coil symmetry and location. Comparisons between the fluoro-less stent placements and controls were performed with the Mann-Whitney U test. All hypotheses were 2-sided and conducted at an alpha level of 0.05.
  
  
  RESULTS
  All 25 ureteral stent placements were performed successfully without the use of fluoroscopy for image guidance. There was no significant difference in age, gender, body mass index, stone size, or complication rates when fluoro-less and conventional stent placements were compared. In addition, grade 1 placement was achieved in 76% of the fluoro-less group and in 64% of the conventional group. Although placement accuracy was higher in the fluoro-less group this was not statistically significant (P = .13).
  
  
  CONCLUSIONS
  Ureteral stent placement without fluoroscopic guidance is feasible. It maintains comparable efficacy and complication rates with conventional ureteral stent placement. This technique allows reduced radiation exposure in patients requiring ureteral stent placement.
authors.affiliation: Department of Urology, Loma Linda University School of Medicine, Loma Linda, CA 92354, USA.
authors.forename: Wayne
authors.initials: W
authors.lastname: Brisbane
authors.forename: Damien
authors.initials: D
authors.lastname: Smith
authors.forename: Amy
authors.initials: A
authors.lastname: Schlaifer
authors.forename: Kirk
authors.initials: K
authors.lastname: Anderson
authors.forename: D Duane
authors.initials: DD
authors.lastname: Baldwin
mesh_terms: D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D015607:Stents; D014513:Ureter; D014514:Ureteral Calculi / Q000628:therapy*; D018666:Ureteroscopy