Antegrade placement of a ureteric stent by a pull-through technique

Internal double-J ureteric stents are valuable in the treatment of ureteric obstruction, obviating the need for an external drainage catheter. Retrograde placement of these stents is often performed by the urologist, or, if such placement fails, antegrade placement is performed by the interventional radiology service. In cases of high-grade obstruction it may be possible to pass a guide wire through the stricture but impossible to do so with a catheter. The authors describe a pull-through technique, which was used to place a ureteric stent in a 65-year-old man with bilateral hydronephrosis. The method consists of gaining control of the distal end of the guide wire by retrieving it through the penile urethra to allow the stenosis to be crossed with a catheter.