Stents are used for the free passage of urine from the kidney to the bladder, in adverse conditions such as postoperative urologic procedures, and previously for lithotripsy and ureteral obstructions.
Ureteric stents may be placed from an antegrade approach by an interventional radiologist or a retrograde approach by a urologist. Stent placement may replace a percutaneous nephrostomy that has been performed in the acute setting. This is popular with patients as it 'internalises' the method of obstruction bypass without the negatives of a nephrostomy.
The majority of stents are plastic, but metallic stents are now available for use in malignancy to reduce the chance of ingrowth into the stent. It is a trade-off as these stents are significantly more expensive than traditional stents.
Stents are typically left for a maximum of months. If long-term stents are required exchanges replacement are usually due to encrustation. Somewhat surprisingly the word 'stent' is actually an eponym, originally named after Charles Stent , a largely forgotten British dentist.
He invented an improved material for forming dental impressions and set up a company to manufacture it. This innovative use was rapidly adopted into practice, and stenting as a concept rapidly segued into multiple specialties.
Despite its eponymic origin, the word stent is not routinely capitalized. Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. The interventional radiologist will then insert a cystoscope a small tube with a camera through your urethra into your bladder.
This cystoscope will then be used to find the opening where the ureter connects to your bladder. After detecting this opening, the IR will thread the ureteral stent into your ureter via the cystoscope. Once the stent is firmly in place, the IR will remove the cystoscope. If both of your ureters are blocked, this will cause both of your kidneys to become weak and can place you at risk for kidney failure. Blocked kidney s require ureteral stent placement.
One end of the tube is inside your kidney and the other end is in your bladder. Before your procedure, your nurse will teach you about what to expect during your ureteral stent placement. Be sure to follow the instructions they give you. On the day of your procedure, a nurse will place an intravenous IV line in one of your veins. To place the stent, your healthcare provider will first insert a cystoscope thin, metallic tube with a camera through your urethra the small tube that carries urine from your bladder to outside your body and into your bladder.
Once they can see this opening, your healthcare provider will thread a ureteral stent through the cystoscope and into your ureter. After the stent is in place, the cystoscope will be removed. A nurse will check your pulse, breathing, and blood pressure regularly. If you feel any pain, your healthcare provider may prescribe pain medication to help you feel more comfortable.
The procedure is usually performed with the patient asleep under general anaesthesia. Sometimes a local anaesthetic, with or without sedation, is administered. During this procedure, a tube with a tiny optic camera is inserted through the Urethra The urethra is the tube that allows urine to pass out of the body. In men, it's a long tube that runs through the penis. It also carries semen in men. In women, the urethra is short and is located just above the vagina.
The bladder is inspected, and the ureteric opening is located. The urologist may use x-ray images taken with a contrast agent Dye DNA, or deoxyribonucleic acid, is the hereditary material in humans and almost all other organisms.
The stent is placed during surgery by sliding it over a guidewire placed in the ureter the tube that drains urine from the kidney into your bladder. Always ask your doctor about the treatment steps and any special instructions. These can differ by hospital and country. Before surgery, someone from your health care team—usually the anaesthesiologist—will assess which type of anaesthesia is appropriate for you.
You may be asked to give a urine sample before the procedure to test for a urinary tract infection. It is important that your care team is informed about your treatment. This includes the doctor and nurses in the hospital, who are responsible for your treatment, as well as your general practitioner and other caregivers with whom you are in contact.
Having your partner, relatives or friends read the information about the procedure can help and can make you feel more comfortable. Write down all your questions to remind you of any important points you need to discuss with your doctor or nurse. The stent will be removed later on.
Sometimes it is used temporarily before stone removal with another procedure. Your blood pressure, heart rate, and pain will be checked regularly. Ask your nurse about visiting hours for friends and relatives.
You will likely leave the hospital shortly after the procedure, when you are able to empty your bladder sufficiently and you have no fever or not in too much pain. You may feel mild to moderate pain in your lower abdomen, and you may have a strong urge to urinate. These symptoms are usually caused by the inserted stent. Medication is available to treat these symptoms. Do ask your doctor. At hospital discharge, your doctor or nurse will give you instructions for rest, driving, and doing physical activities after the procedure.
Because surgical instruments were inserted into your urinary tract, you may experience urinary symptoms for some time after surgery. These symptoms usually disappear in a few weeks. Try to drink fluids often but in small quantities.
Sometimes a blood clot can cause pain colic. The urine contains a substance called urokinase that will dissolve this clot. Tell your doctor right away if bleeding or pain is severe or if problems last longer or worsen after you go home from the hospital. Your doctor may prescribe an antibiotic to treat or prevent an infection or to relieve your pain.
Report any signs of infection——including severe pain, chills, or fever—to your doctor right away. During an appointment in the hospital, your doctor will tell you when the double-J stent needs to be removed.
This can be in several days or within a few weeks. Stents can be removed two different ways. Sometimes a string has been left attached to the end of the stent.
The string can be used to pull on the stent and remove it. If a string is not attached, numbing medication is usually administered, and a small camera called a cystoscope is inserted into the urethra. The cystoscope is advanced into the bladder along with a grasping instrument, which grasps and removes the stent. If a stone is removed during the procedure, it is sent to the laboratory to determine its composition. This may take several weeks.
Based on the laboratory results, along with blood and urine tests taken before treatment, your doctor can determine whether you are at high risk of forming new stones recurrence. The results will be discussed with you during an appointment in the hospital or with your doctor the follow-up. If the results show that you have a high risk of forming more stones, your doctor will do a metabolic evaluation.
This is a series of blood and urine tests to determine the possible causes of your stone formation.
0コメント