Removal of Obstructed or Kinked Ureteral Stents Using Coaxial Dilation Stylet and Safety Wire Introducer Sheath

Abstract

The method of removing obstructed or kinked ureteral stents herein described utilizes an existing coaxial dilation stylet and introducer sheath set that is part of a percutaneous nephroscopy access system. The technique is employed to remove stents that have either formed a tight curl that prevents safe removal or to ensure maintenance of secured ureteral access when replacing obstructed stents after standard methods have not been possible. Passage of an unusual bulk of stone debris after extracorporeal shock wave lithotripsy of large-volume calculi may fill the stent lumen and ureter with sand, causing stent and ureteral obstruction and making stent replacement a difficult task. This technique employs a thin-walled coaxial sheath placed over the problem stent to allow the stent to be extracted safely while the sheath acts as a protective covering and remains in the ureter to preserve access to the upper tract.