Fate of the antegrade ureteric stent - An observational study and quality improvement project
BAUS ePoster online library. Raju J.
Jun 26, 2018; 211316
Mr. Jerry Raju
Mr. Jerry Raju
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Introduction: Follow up of patients with antegrade ureteric stents often involves several specialties and the potential for delayed management and forgotten stents. This study reviews indications and outcomes of antegrade stent procedures at one university hospital to provide prognostic and quality improvement data.

Patients and Methods:Retrospective analysis of 152 antegrade stent procedures in 142 patients over a 27-month period with six-month minimum follow up. Cohorts were studied according to referring specialty, underlying pathology and intended duration of stent placement. Measured endpoints were time to stent removal, stent exchange, death and forgotten stents.

Results: 130 unilateral and 22 bilateral procedures were performed with 99% overall success rate. The majority were requested by urologists (76%) and oncologists (16%). Malignancy (47%) and stone disease (35%) and were the commonest indications. Follow up data was available for 144 successful procedures in 139 patients. Overall, 31 patients (22%) died. 29 of 63 patients (46%) with malignancy died after a median interval of 3.4 months (range 6-688 days). Thirteen (15%) waited over 6 months for stent removal and five (26%) waited over 12 months for stent exchange. Nine patients (6.5%) had forgotten stents, having been in situ for over six months with no intervention planned. Of these, four were inserted for gynaecological malignancy and three for benign disease.

Conclusions: This study provides prognostic information for patients stented for malignant obstruction and highlights hazards of inadequate follow up, causing delays in stent removal and exchange, or the forgotten stent. Interventions are described to minimise these risks.
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