Technical tip: simple concept for minimizing problems with double-J stents with distal end at high level in ureter

A procedure is described to avoid problems with stents that either have been inserted too far in the ureter or have migrated to a level above the bladder and to solve this problem easily if it nevertheless occurs. A knot is tied on the pulling thread at the end of the stent to create a loop of approximately 2 cm. With such a pre-caution, the loop usually remains in the bladder in case of limited stent retraction. For stents that retract to a higher level in the ureter, a special extraction device was constructed from a standard ureteral catheter. These two procedures have so far made it possible to easily remove or adjust the position of 13 of those 15 stents (87%) in 225 patients in whom the distal end became positioned proximal to the ureteral orifice. The procedure was in all cases undertaken without regional or general anesthesia and without the need for ureteroscopy.