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04.07.2020 | Original Article

Feasibility and safety of magnetic-end double-J ureteral stent insertion and removal in children

verfasst von: Marc Chalhoub, Jules Kohaut, Nicolas Vinit, Nathalie Botto, Yves Aigrain, Yves Héloury, Henri Lottmann, Thomas Blanc

Erschienen in: World Journal of Urology | Ausgabe 5/2021

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Abstract

Purpose

The need for surgical removal of a double-J ureteral stent (DJUS) is considered one of its disadvantages. Apart from increased cost, repeated exposure to general anesthesia is a concern in children. Alternative techniques have been described, all failing to become integrated into mainstream practice. Stents with a distal magnetic end, although introduced in the early 1980s, have only recently gained acceptance. We report the feasibility and safety of insertion and removal of a magnetic-end double-J ureteral stent (MEDJUS) in a pediatric population.

Materials and methods

We retrospectively analyzed the use of the Magnetic Black-Star Urotech^® MEDJUS between 11/2016 and 12/2019 in children. Stents were removed in the outpatient clinic using a transurethral catheter with a magnetic tip.

Results

MEDJUS insertion was attempted in 100 patients (65 boys). Mean age was 7.8 years (0.5–18). The stent was placed in an antegrade procedure (n = 47), by a retrograde route (n = 10), and during open surgery (n = 43). Stent insertion was successful in 84 cases (84%). All 16 failures occurred during the antegrade approach in laparoscopic pyeloplasty, with inability to push the stent and its magnet through the ureterovesical junction in 14. Magnetic removal was attempted in 83 patients, successful in 81 (98%). There was no added morbidity with the MEDJUS.

Conclusions

The use of MEDJUS is a safe and effective strategy that obviates the need for additional general anesthesia in children. Its insertion is similar to that with regular DJUS, and its easy and less time-consuming removal benefits both the patient and the hospital and validates its clinical use.

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Finney RP (1978) Experience with new double J ureteral catheter stent. J Urol 120(6):678–681. https://doi.org/10.1016/S0022-5347(17)57326-7CrossRefPubMed

Donahue RP et al (2018) Evolution of the ureteral stent: the pivotal role of the gibbons ureteral catheter. Urology 115:3–7. https://doi.org/10.1016/j.urology.2018.02.007CrossRefPubMed

Kawahara T et al (2012) Ureteral stent retrieval using the crochet hook technique in females. PLoS ONE 7(1):e29292. https://doi.org/10.1371/journal.pone.0029292CrossRefPubMedPubMedCentral

Jones JS (2002) Shortened pull-string simplifies office-based ureteral stent removal. Urology 60(6):1095–1097. https://doi.org/10.1016/s0090-4295(02)02000-9CrossRefPubMed

Rassweiler M-C, Michel M-S, Ritter M, Honeck P (2017) Magnetic ureteral stent removal without cystoscopy: a randomized controlled trial. J Endourol 31(8):762–766. https://doi.org/10.1089/end.2017.0051CrossRefPubMed

Söylemez H, Sancaktutar AA, Bozkurt Y, Atar M, Penbegül N, Yildirim K (2011) A cheap minimally painful and widely usable alternative for retrieving ureteral stents. Urol Int 87(2):199–204. https://doi.org/10.1159/000327610CrossRefPubMed

McCann ME, Soriano SG (2019) Does general anesthesia affect neurodevelopment in infants and children? BMJ 367:l6459. https://doi.org/10.1136/bmj.l6459CrossRefPubMed

Shao H, Liu P, Zhang H, Chen C, Lin X (2018) Noncystoscopic removal of retained ureteral stents in children. Medicine (United States) 97(1):e9540. https://doi.org/10.1097/MD.0000000000009540CrossRef

Bockholt NA, Wild TT, Gupta A, Tracy CR (2012) Ureteric stent placement with extraction string: no strings attached? BJU Int 110(11 C):E1069–E1073. https://doi.org/10.1111/j.1464-410X.2012.11219.xCrossRefPubMed

10.

Doizi S et al (2017) First clinical evaluation of a new single-use flexible cystoscope dedicated to double-J stent removal (Isiris^TM): a European prospective multicenter study. World J Urol 35(8):1269–1275. https://doi.org/10.1007/s00345-016-1986-0CrossRefPubMed

11.

Soria F et al (2018) Evaluation of a new design of Antireflux-biodegradable ureteral stent in animal model. Urology 115:59–64. https://doi.org/10.1016/j.urology.2018.02.004CrossRefPubMed

12.

Helmy T, Blanc T, Paye-Jaouen A, El-Ghoneimi A (2011) Preliminary experience with external ureteropelvic stent: alternative to double-J stent in laparoscopic pyeloplasty in children. J Urol 185(3):1065–1069. https://doi.org/10.1016/j.juro.2010.10.056CrossRefPubMed

13.

Braga LHP, Lorenzo AJ, Farhat WA, Bägli DJ, Khoury AE, Pippi Salle JL (2008) Outcome analysis and cost comparison between externalized pyeloureteral and standard stents in 470 consecutive open pyeloplasties. J Urol 180(4 Suppl.):1693–1699. https://doi.org/10.1016/j.juro.2008.05.084CrossRefPubMed

14.

Macaluso JN, Deutsch JS, Goodman JR, Appell RA, Prats LJ, Wahl P (1989) The use of the magnetip double-J ureteral stent in urological practice. J Urol 142(3):701–703. https://doi.org/10.1016/S0022-5347(17)38858-4CrossRefPubMed

15.

Taylor WN, McDougall IT (2002) Minimally invasive ureteral stent retrieval. J Urol 168(5):2020–2023. https://doi.org/10.1016/S0022-5347(05)64286-3CrossRefPubMed

16.

Mitchell A, Bolduc S, Moore K, Cook A, Fermin C, Weber B (2019) Use of a magnetic double J stent in pediatric patients: a case–control study at two Canadian pediatric centers. J Pediatr Surg. https://doi.org/10.1016/j.jpedsurg.2019.03.014CrossRefPubMedPubMedCentral

17.

Blanc T et al (2013) Retroperitoneal laparoscopic pyeloplasty in children: long-term outcome and critical analysis of 10-year experience in a teaching center. Eur Urol 63(3):565–572. https://doi.org/10.1016/j.eururo.2012.07.051CrossRefPubMed

18.

Almeras C et al (2017) Double J stent removal’s cost estimate using a re-sterilizable fibroscope in a French private structure. Prog Urol 27(16):1031–1035. https://doi.org/10.1016/j.purol.2017.07.240CrossRefPubMed

19.

Chu DI et al (2018) Outcomes of externalized pyeloureteral versus internal ureteral stent in pediatric robotic-assisted laparoscopic pyeloplasty. J Pediatr Urol 14(5):450.e1–450.e6. https://doi.org/10.1016/j.jpurol.2018.04.012CrossRef

20.

Mykulak DJ, Herskowitz M, Glassberg KI (1994) Use of magnetic internal ureteral stents in pediatric urology: retrieval without routine requirement for cystoscopy and general anesthesia. J Urol 152(3):976–977. https://doi.org/10.1016/S0022-5347(17)32634-4CrossRefPubMed

21.

Rassweiler M-C, Michel M-S, Ritter M (2014) Black-Star®—magnetic DJ removal. J Urol 191(4S):e949–e950

22.

Oonnell L, Broe MP, Rooney D, Elhag S, Cheema I, McGuire BB (2018) Magnetic stent removal in a nurse Led Clinic; a nine month experience. Iran Med J 111(2):687

23.

Singh KM, Goel A, Shankhwar SN, Dalela D (2004) Confirmation of the correct placement of lower end of DJ stent during open surgery: point of technique. Int Urol Nephrol 36(3):335–336. https://doi.org/10.1007/s11255-004-0924-zCrossRefPubMed

24.

Kurien T, Price KR, Pearson RG, Dieppe C, Hunter JB (2016) Manipulation and reduction of paediatric fractures of the distal radius and forearm using intranasal diamorphine and 50% oxygen and nitrous oxide in the emergency department: a 2.5-year study. Bone Jt J 98-B(1):131–136. https://doi.org/10.1302/0301-620X.98B1.36118CrossRef

25.

Mehrabi A et al (2019) Surgical outcomes after pediatric kidney transplantation at the University of Heidelberg. J Pediatr Urol 15(3):221.e1–221.e8. https://doi.org/10.1016/j.jpurol.2019.01.007CrossRef

26.

Administration UFaD (2016) FDA Drug Safety Communication: FDA review results in new warnings about using general anesthetics and sedation drugs in young children and pregnant women. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-review-results-new-warnings-about-using-general-anesthetics-and. Accessed 3 Aug 2018

Titel: Feasibility and safety of magnetic-end double-J ureteral stent insertion and removal in children
verfasst von: Marc Chalhoub
Jules Kohaut
Nicolas Vinit
Nathalie Botto
Yves Aigrain
Yves Héloury
Henri Lottmann
Thomas Blanc
Publikationsdatum: 04.07.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 5/2021
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-020-03339-0

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Feasibility and safety of magnetic-end double-J ureteral stent insertion and removal in children