Cystoscope-free ureteral stent removal: a safe and effective method during the COVID-19 pandemic.

Abstract

Ureteral stent must be removed within a certain period, usually performed under the cystoscope. However, cystoscopic operations procedures carry risks such as urethral injury, hemorrhage, and infection. This study aimed to implement a cystoscope-free method for ureteral stent removal during the COVID-19 pandemic to mitigate the complications associated with cystoscopy, reduce the risk of cross-infection, and conserve medical resources and time. We retrospectively reviewed 33 patients who underwent ureteral stent removal at our institution between August and December 2022 during the COVID-19 pandemic. A simple device, consisting of an F6 or F8 gastric tube with the front end passing through a 3-0 Prolene line was utilized to extract the double-J stents without cystoscopic assistance. The gastric tube with the line was inserted into the urethra to drain urine from the bladder, saline was injected into the bladder, and the gastric tube was rotated with the line for 4-5 weeks, after which the stent tube was removed by gently pulling it outward. Perioperative characteristics assessed included operation time, pain score, stent removal success rate, postoperative complications, and reasons for stent removal failure. Among the 33 cases included in the study, 17 were males and 16 were females; 20 patients were older than 14 years while 13 were younger. Cystoscope-free stent removal was performed in all cases, with a success rate of 96.9% (32 patients), including 25 cases (78.1%) completed in one operation, four cases (12.5%) in two operations, and three cases (9.4%) in three operations. The mean extubation time was 4.3 ± 1.5 minutes, and the average pain score was 2.1 ± 0.7. No serious postoperative complications were noted. Cystoscope-free ureteral stent removal can be executed by a single physician, demonstrating simplicity, safety, effectiveness, and fewer complications. This method reduces the risk of cross-infection and conserves medical resources and time during the COVID-19 pandemic, making it suitable for both adults and children.