Intravascular double J stent migration: A case report, review, and management algorithm

A double J stent (DJS) is the main therapy for ureteral obstruction when conservative treatment fails. Antegrade migration in the bladder – or retrograde migration in the ureter – are well-known complications. We present a case with intravascular migration of a DJS into the inferior vena cava. Inferior venocavagraphy confirmed the position of the stent, and thrombus formation was excluded at its tip. The stent was retracted endoscopically. After the procedure, limited contrast leakage was seen at the perforation site on venography. The current available literature is reviewed. Based on this, a management algorithm is drawn up

Sacral neuromodulation: standardized tined lead implantation technique: two-year clinical outcome and sensory response upon lead stimulation comparing the use of the curved versus straight stylet

OBJECTIVES To assess clinical follow-up data over 24 months using the standardized tined lead implantation technique, comparing the use of the curved vs straight stylet. PATIENTS AND METHODS Single tertiary center, prospective study (August 2013 - June 2015) involving 40 patients with overactive bladder and 15 with non-obstructive urinary retention refractory to first-line treatment. PRIMARY OUTCOME successful tined lead procedure; intention to treat analysis at 12 and 24 months. Secondary outcome: number of optimal electrode configurations during programming. Statistical analysis was performed by plain non-parametric tests for numeric and categorical data. RESULTS 33/35 (94%) patients implanted with the curved stylet had a successful tined lead procedure versus 13/20 (65%) implanted with the straight stylet (p=0.005). Intention to treat analysis at 12 and 24 months was 94% and 91% for the patients with the curved stylet compared to 65% and 45% for those with the straight stylet (p=0.002 and p<0.001). 60% and 25% of the electrode configurations in the curved group were considered optimal and bad in comparison to 40% and 37% in the straight group (p<0.001). The main limitation is the non-randomized study design. CONCLUSIONS The use of the standardized implantation technique with the curved stylet leads to more successful tined lead procedures, better success rates after 2-years follow-up and more optimal electrode configurations when compared to use of the straight stylet placement. This article is protected by copyright. All rights reserved