Background: The aim of the study was to evaluate a technique of retrograde double pigtail stent placement using a flexible cystoscope and fluoroscopic control in outpatients under local anesthesia. Patients and Methods: Seventy consecutive patients (79 ureters) requiring stent placement or replacement were included in the study. The procedures were performed on an outpatient basis under local anesthesia with the assistance of a C-arm fluoroscopy unit. After application of topical anesthetic, a flexible cystoscope was inserted into the bladder and a guidewire was advanced into the renal pelvis. The cystoscope was removed and a double pigtail stent was advanced over the wire under fluoroscopic control. Results: Overall, 74 out of 79 attempts (93.6%) were successful. Success was achieved in 54 (91.5%) of the 59 stent placements and in all 20 (100%) stent replacements. The procedure was rated as ‘acceptable’, ‘uncomfortable’, and ‘painful’ in 47, 5, and 2 patients, respectively, for stent placement and 14, 2, and 0 patients, respectively, for stent replacement. Conclusion: Stent placement and replacement can be performed on an outpatient basis under local anesthesia using a flexible cystoscope and fluoroscopic control. The procedure is safe and effective and can be easily tolerated by the vast majority of patients.

Keywords:
Flexible cystoscopy, Fluoroscopy, Local anesthesia, Stents • Ureter
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© 2008 S. Karger AG, Basel
2008
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