Antegrade ureteral stent placement: positioning without use of a retraction string

To evaluate a simple method of antegrade ureteral stent insertion allowing optimal positioning of the stent without the use of a retraction string.

Seventeen stents were placed in sixteen patients with ureteral obstruction. Materials included a long vascular introducer sheath and radiopaque markers on the tips of both the sheath and the pusher catheter. For optimal positioning of the proximal pigtail in the renal pelvis, the distal end of the sheath was used to hold a large portion of the pigtail in the extended state prior to its deployment.

All stent placements were successful. In one case, the tip of the proximal pigtail was caught in a lower-pole calix. In another case, repeat stent placement was necessary because of recurrent stricture several months after removal of the first stent. All stents functioned properly, as demonstrated by follow-up nephrostography 2 or 3 days after each procedure.

The insertion method we describe is simple, easy to perform, and fast and avoids the risks associated with the use of a retraction string.