Ureteral stents are common medical devices made of flexible materials (such as polyurethane, silicone, or PEBAX). They are widely used to relieve ureteral obstruction and maintain normal urine flow from the kidneys to the bladder. Their unique pigtail-shaped design (located in the renal pelvis and bladder respectively) ensures stable positioning and effectively prevents displacement. With advancements in materials and technology, modern ureteral stents have been continuously optimized in terms of biocompatibility, antibacterial properties, and placement techniques.
I. Main Indications for Ureteral Stents
1. Ureteral Stone-Related Obstruction
Ureteral stents are commonly used to relieve urinary tract obstruction caused by stones, especially before and after laser lithotripsy or ESWL (extracorporeal shock wave lithotripsy), to improve urine flow and reduce postoperative edema and complications.
2. Urinary Tract Stricture Caused by Tumors For patients with urinary system or pelvic tumors, tumor compression of the ureter can cause obstruction. Stent placement can restore urine excretion function, alleviate hydronephrosis, and reduce kidney function deterioration. 3. Postoperative Support After ureteral surgery (such as ureteroplasty) or complex urological surgery, stent placement can prevent re-obstruction caused by postoperative edema and promote healing. 4. Infectious Obstruction In cases of infectious urinary tract obstruction (such as acute pyelonephritis with pyonephrosis), stent placement can quickly restore drainage and relieve pressure. 5. Complex Urinary Tract Structural Abnormalities For congenital or acquired urinary tract strictures, ureteral stents provide a solution for long-term or short-term drainage.II. Surgical Procedure for Ureteral Stent Placement
1. Preoperative Preparation: Imaging Assessment: Preoperative assessment of the obstruction location and severity using ultrasound, CT, or IVU (intravenous urography). Patient Management: Preoperative infection control, electrolyte remediation, and patient disclosure of associated risks.
2. Procedure: Endoscopic Guidance: Locating the ureteral orifice using a cystoscope or ureteroscope.
Guidewire Insertion: A flexible guidewire is inserted into the renal pelvis via the endoscope to provide a path for stent placement.
Stent Implantation: The ureteral stent is inserted into the ureter along the guidewire, ensuring its ends are located in the renal pelvis and bladder, respectively. Contrast Confirmation: Intraoperative injection of contrast agent confirms correct stent placement.