Ureteral stents and flexible ureterorenoscopy

Area of Science:

• Urology
• Minimally Invasive Surgery
• Endourology

Background:

• Ureteroscopy is a common procedure for treating upper urinary tract stones and other pathologies.
• Effective dilation of the intramural ureter is crucial for successful ureteroscopy, but current methods present challenges.
• No single dilation method is universally ideal, posing risks and varying in efficacy.

Purpose of the Study:

• To evaluate the safety, reliability, and trauma associated with different intramural ureteral dilation methods.
• To identify the optimal method for ureteral dilation prior to ureteroscopy based on clinical experience.

Main Methods:

• Review of clinical experience with various ureteral dilation techniques for ureteroscopy.
• Focus on the use and outcomes of indwelling ureteral stents for pre-procedure dilation.
• Comparison of stent-based dilation with other available methods in terms of safety and efficacy.

Main Results:

• While several dilation methods exist and are effective in expert hands, none are considered ideal.
• Ureteral stents, when left indwelling for one to two weeks, were found to be the preferred method.
• This stent-based approach demonstrated superior safety, reliability, and reduced trauma compared to alternatives.

Conclusions:

• Indwelling ureteral stents for 1-2 weeks represent a safe, reliable, and least traumatic method for intramural ureteral dilation.
• This technique is recommended for optimizing outcomes in patients undergoing ureteroscopy.
• Further research may explore long-term outcomes and patient-reported experiences with this method.