MAGnetic REtriaval Device for Minimally Invasive Ureter Stent Removal.

Abstract

Purpose: To assess the effectiveness and pain intensity associated with magnetic ureteral stent removal using a retriever, without the aid of ultrasound guidance. Methods: We prospectively enrolled 100 patients who underwent retrograde rigid and flexible ureterorenoscopy with or without laser lithotripsy for ureteronephrolithiasis treatment from September 2021 to June 2023. These patients were assigned in two groups. Group 1 underwent the traditional ureteral stent insertion, while Group 2 underwent magnetic ureteral stent insertion. Both insertion and removal times were documented. The indwelling time for ureteral stents was 14 days. One group underwent stent removal via flexible cystoscopy using grasping forceps and the other group using just a magnetic retriever, without the aid of ultrasound guidance. The numeric pain rating scale, recommendation rate, and a standardized self-answered ureter stent symptoms questionnaire (USSQ) were obtained directly after stent removal. Results: Both groups presented comparable characteristics in factors such as age, body mass index, history of stone treatments, procedure type, and complication rates during and post-surgery. Time taken for ureteral stent insertion did not differ significantly between the groups (131.2 seconds for Group 1 vs 159.1 seconds for Group 2). However, the stent removal time (152.1 seconds for Group 1 vs 35.4 seconds for Group 2) and pain intensity (6 for Group 1 vs 2 for Group 2) were significantly lower for Group 2. Furthermore, five out of the six sections of the USSQ showed significantly better results for Group 2. Conclusions: The use of magnetic ureteral stents, as a safe and efficient alternative to conventional ureteral stents, not only eliminates the need for cystoscopy but also conserves resources and reduces patient discomfort.