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. 2024 Aug;18(8):234-238.
doi: 10.5489/cuaj.8880.

Safety and efficacy of ultrasound-assisted bedside ureteric stent placement A prospective, single-institution study

David Chung  1 , Ryan Ramjiawan  1 , Gregory Hosier  1
Affiliations

Safety and efficacy of ultrasound-assisted bedside ureteric stent placement A prospective, single-institution study

David Chung et al. Can Urol Assoc J. 2024 Aug.

Abstract

Introduction: Previous studies have demonstrated the feasibility of bedside placement of ureteric stents; however, they have traditionally required two skilled operators and were associated with some stent malposition especially for proximal ureteric obstruction. We sought to investigate the efficacy and safety of a modified technique for ultrasound-assisted bedside ureteric stent insertion without the presence of a skilled assist.

Methods: A single institution prospective study was performed from April-August 2023. Indications for stenting included infection, renal insufficiency, or intractable colic. Exclusion criteria included age <18 years, hemodynamic instability, and patients with history of chronic pain. Point-of-care ultrasound (POCUS) was used to confirm wire placement in the kidney and presence of a hydronephrotic drip from a 5 French ureteric catheter was used to confirm placement beyond the level of obstruction.

Results: Of 28 patients, all patients underwent successful bedside ureteric stent placement. Mean age was 64.9 years and mean body mass index (BMI) was 33.2. Proximal ureter obstruction was present in 52% of patients and mid/distal obstruction in 48%. In cases with obstructing stones, the mean stone size was 8.1 mm with a range of 4-15 mm. Infection was the indication for stent placement in most patients (71%), followed by pain (4%) and acute kidney injury (AKI) (4%). All patients who underwent successful stent placement had presence of hydronephrotic drip from the ureteric catheter.

Conclusions: Ultrasound-assisted bedside ureteric stent insertion without a skilled assist is a safe and feasible option for management of acute ureteral obstruction. Presence of hydronephrotic drip can indicate successful access beyond the level of obstruction as an alternative to POCUS.

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Conflict of interest statement

COMPETING INTERESTS: The authors do not report any competing personal or financial interests related to this work.

Figures

Figure 1
Figure 1
Bedside ureteric stent insertion setup.
Figure 2
Figure 2
Renal point-of-care ultrasound with wire visualization.
See this image and copyright information in PMC

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