Ureteric stent card register - a 5-year retrospective analysis
Vincent C Y Tang1, John Gillooly, Elaine W Y Lee
1Department of Urology, Epsom and St Helier University Hospitals NHS Trust, Surrey, UK. vincetang@hotmail.com
Annals of the Royal College of Surgeons of England
|March 8, 2008
Summary
A retrospective review found that the current ureteric stent tracking system was ineffective. Despite overdue stents, no patients experienced harm, suggesting other safeguards are in place.
Area of Science:
- Urology
- Medical Device Tracking
Background:
- Ureteric stenting is a common procedure with risks associated with forgotten stents.
- Morbidity and mortality are documented risks of retained ureteric stents.
Purpose of the Study:
- To evaluate the effectiveness of a stent register in preventing lost or overdue ureteric stents.
- To determine if a stent register is crucial for patient safety in urological procedures.
Main Methods:
- A retrospective review of 203 patients undergoing ureteric stenting over a 5-year period.
- Analysis of stent cards, patient records, and theatre logs, with patient contact for missing removal data.
Main Results:
- The stent card register identified 191 patients; an additional 12 were found via theatre logs.
- 11 stents were overdue, and 51 had no removal record; most forgotten stents were removed at other hospitals.
- Nine patients died with stents in situ before the scheduled removal date.
Conclusions:
- The current stent card tracking system is ineffective due to infrequent review.
- Despite system flaws, no patients suffered significant harm, indicating other safety measures are effective.
- A computerized stent register or shared patient-clinician responsibility could improve tracking.
Related Concept Videos
01:30Urinary Tract Calculi III: Medical Management
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
01:25Urinary Tract Calculi VI: Surgical Management
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
01:19Urodynamic Studies: Uroflowmetry
Uroflowmetry is a non-invasive urodynamic test designed to measure various aspects of urination, including volume, flow rate, and the time to void. This test is crucial for diagnosing and assessing conditions such as bladder outlet obstruction, bladder dysfunction, incomplete bladder emptying, incontinence, and urinary tract blockages caused by benign prostatic hyperplasia (BPH) and urethral strictures.Pre-Test Instructions:Before a uroflowmetry test, patients are typically advised to drink...
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography
IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
01:26Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
01:22Ureters
The ureters are retroperitoneal tubes located on either side of the vertebral column. They are responsible for transporting urine from each kidney to the urinary bladder. These tubes have thick walls and are approximately 25-30 cm long. Their diameter is around 10 mm at the renal pelvis, gradually narrowing to 1 mm as the ureter obliquely enters the posterior bladder wall through the ureteric orifices. The shape of these orifices is slit-like, which helps to prevent urine backflow toward the...