Ureteric stents on extraction strings: a systematic review of literature.
Short-term ureteric stents are commonly placed after ureteroscopy. The removal usually entails having a cystoscopy, but recently, endourologists have been using stents with extraction strings attached to them for ease of removal. We wanted to conduct a systematic review of literature looking at the outcomes of ureteric stents with extraction strings attached to them. Our objective was to investigate the use, morbidity, tolerability, complications, associated cost, and patient preference of stents with extraction strings attached to them. All studies in English language (between 1990 and 2015) where stents on extraction strings were either self-removed by patients or removed by physician were included. A total of eight studies (1279 patients) were included, of which 483 (38 %) patients had extraction strings for removal. There seemed to be no overall difference in pain scores or urinary symptoms between patients with and without extraction strings, but nearly 10 % of patients suffered stent dislodgement in the group with extraction strings attached. Overall stent dwell time was lower in patients who had their stents removed via extraction strings, and majority of them were able to remove their stents at home. Our study suggests that stents with extraction strings are easy for patient self-removal and can reduce the stent dwell time for patients, thus reducing the duration of morbidity and physical and financial burden to patients. However, this must be balanced against a risk of stent dislodgement and, hence, may not be a good option in all patients.
Department of Urology, University Hospital of Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK.
Rachel
R
Oliver
Department of Urology, University Hospital of Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK.
Hannah
H
Wells
Department of Urology, Tenon Hospital, University Pierre and Marie Curie, Paris, France.
Olivier
O
Traxer
Department of Urology, Klinikum Sindelfingen-Böblingen, Sindelfingen, Germany.
Thomas
T
Knoll
Urology Fellow, Bristol Urological Institute, Bristol, UK.|EAU Young Academic Urologists Group, Arnhem, The Netherlands.
Omar
O
Aboumarzouk
Leeds Teaching Hospital NHS Trust, Leeds, UK.
Chandra S
CS
Biyani
Department of Urology, University Hospital of Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK. bhaskarsomani@yahoo.com.|EAU Young Academic Urologists Group, Arnhem, The Netherlands. bhaskarsomani@yahoo.com.
Bhaskar K
BK
Somani
D020878:Device Removal / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D010146:Pain / Q000453:epidemiology* / Q000209:etiology; D010147:Pain Measurement; D057240:Patient Preference; D015607:Stents / Q000009:adverse effects*; D014513:Ureter / Q000601:surgery; D014514:Ureteral Calculi / Q000601:surgery*; D018666:Ureteroscopy / Q000009:adverse effects / Q000295:instrumentation*
Extraction; Stent; String; Ureteric; Ureteroscopy