Abstract
In 36 patients with renal pelvic or caliceal calculi scheduled for extracorporeal shock wave lithotripsy (SWL), the upper urinary tract was accessed with standard guidewires passed under direct vision through a flexible cystoscope using 2% lidocaine anesthesia. Initially, in 32 patients, an attempt was made to pass a 4.8F double-pigtail catheter through the endoscope. In 27 patients (86%), the catheters were passed successfully. In the remaining patients, open-end ureteral catheters were passed over the guidewires. The procedures were performed in the lithotripsy suite on the standard hospital stretcher. Catheter position was verified after SWL by a plain radiograph. In three patients, the stents were located distal to the renal pelvis and required removal or replacement. Insertion of double-pigtail ureteral stents prior to SWL therapy via flexible cystoscopy in the lithotripsy suite is a safe and cost-effective technique that can be performed with local anesthesia. Accurate placement could be assessed better by fluoroscopic monitoring.
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