Outcomes of outpatient ureteral stenting without fluoroscopy at Groote Schuur Hospital, Cape Town, South Africa

Background. Ureteral stenting is generally a theatre-based procedure that requires a multidisciplinary team and on-table imaging. Limited hospital bed numbers and theatre time in our centre in Cape Town, South Africa, have led us to explore an alternative approach. Objectives. To see whether outpati...

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Bibliographic Details
Published in:South African medical journal 2018-06, Vol.108 (6), p.506-510
Main Authors: Jaumdally, S.Z., Kowlessur, B., Wicht, J., Lazarus, J., Kaestner, L., Cassim, F., Van den Heever, A.P., Moolman, C., Kolia, M.E., Sinha, S., Pinto, G., Govender, P., Salukazana, S., Panackal, A., Dewar, M., De Wet, E., De Jager, S., Jehle, C.H.
Format: Article
Language:English
Subjects:
Ambulatory surgery
Fluoroscopy
Local anesthesia
Methods
Patient outcomes
Ureteral stents
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Summary:Background. Ureteral stenting is generally a theatre-based procedure that requires a multidisciplinary team and on-table imaging. Limited hospital bed numbers and theatre time in our centre in Cape Town, South Africa, have led us to explore an alternative approach. Objectives. To see whether outpatient insertion of ureteric stents under local anaesthesia without fluoroscopy was a possible and acceptable alternative to theatre-based ureteral stenting. Methods. Ureteral stenting (double-J stents and ureteric catheters) was performed with flexible cystoscopy under local anaesthesia and chemoprophylaxis, but without fluoroscopic guidance, in an outpatient setting. Every patient had an abdominal radiograph and an ultrasound scan of the kidney after the procedure to confirm stent position. Results. Three hundred and sixteen procedures (276 double-J stents and 40 ureteric catheters) were performed in 161 men and 155 women. The overall success rate for the procedures was 85.4%, independent of gender (p=0.87), age (p=0.13), type of device inserted (p=0.81) or unilateral/bilateral nature of the procedure (p=1.0). Procedures with a successful outcome were performed in a significantly (p5 experienced a significantly (p=0.02) greater proportion of failure (27.3%) than patients with a pain score of ≤5 (12.5%). Difficulties were encountered in 23.7% of procedures, with a significantly higher proportion being registered in failed interventions compared with successful ones (82.6% v. 13.7%; p
ISSN:0256-9574
2078-5135
DOI:10.7196/SAMJ.2018.v108i6.12983