A modified method for urology residents to replace ureteral stent after previous failure in patients with middle or lower ureteral lesions

Objective: To investigate the safety and reliability of ureteral stent replacement by urology residents using a safety wire in patients with previous failure in the outpatient department. Methods Thirty-eight patients who needed regular ureteral stent replacement in the outpatient department from January 2020 to April 2023 were enrolled, they all underwent at least once failure in previous replacement, and were randomly divided into experimental group (n = 20) and control group (n = 18). In the experimental group, ureteral stent replacement was performed by indwelling safety guide wire in the original stent, while in the control group, the stent was replaced by the indwelling guide wire after completely pulling out the original stent. According to the duty schedule, four urology residents with similar cystoscopy operating skills were randomly assigned to perform stent replacement in the outpatient department. For cases that the replacement failed, the superior physician performed the operation under intraspinal anesthesia Results In the experimental group, all 20 patients (69 times) accepted successful ureteral stent replacement by the residents, and there were no adverse reactions such as low back pain observed. In the control group, 4 (7 times) out of 18 patients (61 times) failed the replacement by the residents before superior physician performed the operation under intraspinal anesthesia. Conclusion Ureteral stents can be successfully replaced by indwelling safety wire in patients with middle or lower ureteral lesions, or follicular trigone of bladder. The procedure is minimally invasive and easy to learn for the residents. Moreover, This method is safe and less costly for the patients