Fluoroscopy-guided double-J ureteral stent removal using a novel metallic hook device "Kagibo" in women: A...

The replacement of double-J ureteral stents (DJ stents) is a routine procedure in urology that conventionally requires cystoscopy. We developed a new medical device, the "Kagibo," for removing DJ stents without cystoscopy in women. This study aimed to report the usefulness and safety of Kagibo in DJ stent removal in women. This retrospective study included a total of 34 female patients with a median age of 67 years (range: 44-87 years) who required DJ stent replacement between April and July 2024. The procedure was performed with the patients in the supine position without pain management. DJ stent replacement was performed as follows: the Kagibo was inserted into the bladder through the external urethral orifice; the distal end of the DJ stent was hooked to the Kagibo under fluoroscopic guidance; and the Kagibo was pulled outside the urethra, and the old DJ stent was replaced with a new stent. We defined success as cases in which DJ stents could be removed with the Kagibo and complications as cases requiring additional procedures or drug therapy associated with DJ stent removal. We retrospectively investigated the success rates and incidence of complications. The success rate of DJ stent removal using the Kagibo was 100%. No complications were observed. Our findings indicate that the Kagibo allows for the safe and effective removal of DJ stents without cystoscopy in women.