Новый метод удаления внутреннего мочеточникового стента под ультразвуковым контролем у женщин после дробления камней

Objective : to develop a rapid, convenient and safe method for ureteral stent removal in women after lithotripsy. Materials and methods : We conducted a retrospective multicentre study (time frame: February 2014 – March 2016) that included 122 female patients after lithotripsy: 46 of them were in the control group (where the stent was removed in a conventional way using cystoscope 22 Ch), 76 patients were in the experimental group (where the stent was removed using «spiral device» 15 Ch under ultrasound guidance). The exclusion criteria were the following: pelvic organ prolapse (stage 2 or greater according to POP-Q system), presence of stent complications (stent displacement or encrustation). We evaluated the duration of stents removal, pain intensity according to Visual Analog Scale for Pain, and the likelihood of complications. Results. Stents were successfully removed in all patients. No complications were observed in both groups. Stent removal in the experimental group was approximately 4 sec longer than that in the control group (p = 0,0056). The difference was statistically significant, but didn»t have great clinical importance. Difference in pain intensity according to Visual Analog Scale for Pain was the most significant; patients in experimental group were found to have lower levels of pain (p = 4 × 10 –5). Conclusion . Proposed ultrasound guided method for ureteral stent removal by a loop in women after lithotripsy appears to be more comfortable. It is characterized by lower pain intensity according to Visual Analog Scale for Pain comparing to conventional method with cystoscope; it does not imply any additional costs associated with usage of endoscopic equipment, its sterilization and working time of a nurse. Therefore, the method can be considered as a good option for outpatient practice in patients without complications; moreover it can be recommended for stent removal in pregnant women as soon as the technique does not require the use of ionising radiation.