Ureteral stents are widely used to maintain luminal patency in the management of both benign and malignant causes of ureteric obstruction. These so called double-J stents are typically placed using an anterograde approach via nephrostomic access1. However, these need to be replaced every 4-6 months due to stent migration, encrustation, obstruction and infection2. Exchange may be performed using a retrograde or anterograde approach, with the former being preferred as nephrostomic access is not required3. Traditionally, retrograde stent exchange is performed under direct visualization using a...

All the patients are from our tertiary Women’s hospital where there is no Urology cover. Patients were identified retrospectively from our radiological information system database. Between January 2012 and December 2016, we treated 79 women (mean age 55 years, range 32-79). All the patients had ureteric obstruction due to compression by pelvic malignancies or their secondary lymphadenopathy except for one who had ureteric obstruction due to scarring following cystectomy for endometriosis (Fig. 1). All the patients had stents previously placed via an anterograde approach through...

Procedure Stent exchange was successful in 234/238 (98%) of cases. In two cases, the distal ends of the stents could not be snared due to extrinsic compression by large pelvic masses causing distortion of anatomy and angulation of the stents. In one case, the stent was snared and externalised per urethra using modified loop snare technique, however there was extreme difficulty advancing various guidewires due to encrustations within the stent. The stent was hence removed. In one case, failure was due to loss of access...

The aim of this study was to evaluate the feasibility of fluoroscopic retrograde transurethral ureteric stent exchange using modified wire loop snare technique as an alternative to cystoscopic replacement. Based on review of our practice, the modified wire loop snare technique is safe, effective and well tolerated by patients. Major complications are rare. This approach offers several advantages over the traditional cystoscopic approach for ureteric stent exchange: The procedure is well tolerated by most patients with just moderate sedation. General anaesthesia is usually not required....

A. L. Lai, L. M. H. W. Toh, K. D. Zhuang, K. Damodharan, F. G. Irani, A. Gogna, B. S. Tan, K. H. Tay, S. Chandramohan Department of Vascular and Interventional Radiology, KK Women's and Children's Hospital, Singapore Email: [email protected]

Uthappa MC, Cowan NC. Retrograde or antegrade double-pigtail stent placement for malignant ureteric obstruction? Clin Radiol 2005;60:608-12. Chew BH, Knudsen BE, Denstedt JD. The use of stents in contemporary urology. Curr Opin Urol 2004;14:111-5. Grasso RF, Faiella E, Cazzato RL, Luppi G, Vescovo RD, Giurazza F, et al. Retrograde fl uoroscopy-guided trans-urethral exchange of ureteral stents: Comparison of direct grasping vs. modifi ed snare. Indian J Radiol Imaging 2013;23:347-50. Yedlicka JW Jr, Aizpuru R, Hunter DW, Castañeda-Zúñiga WR, Amplatz K. Retrograde replacement of internal double-J...