Bruno-Snelling, I

Emmerson, S

Imedi, A

McCaig, F

Motallebzadeh, R

English

UCL Discovery

Removing transplant ureteric stents using the Coloplast Isirisdisposable flexible cystoscope and portable monitorAuthors: A. Imedi, I. Bruno-Snelling, S. Emmerson, R Motallebzadeh,  F. McCaigCENTRE FOR TRANSPLANTATIONDEPARTMENT OF RENAL MEDICINEIntroductionIn our renal unit, kidney transplant ureteric stents have traditionally been removed in operating theatresusing re-usable diagnostic flexible cystoscopes with stent graspers. An on-going challenge was findingsuitable time slots between busy elective surgical lists. Delays in stent removals adversely affect urinarytract infection (UTI) rates and unnecessary hospital stays. At the Royal Free Hospital we introducedoutpatient disposable flexible cystoscope use in a bid to alleviate these issues and improve our patientpathway . A cost-benefit analysis of this scheme was conducted before commencement.MethodsKidney transplant recipients had their ureteric stents removed usingdisposable flexible cystoscopes. Exclusion criteria: (i) patient withperitoneal dialysis catheters, scheduled for GA removal, during whichtheir stent(s) was removed concomitantly (ii) complex urologicalissues (iii) patient choice. An infection control team assessedequipment and environment suitability for the procedures. Pre-procedure prophylactic antibiotics were given 30 minutes before stentremoval. The procedure was performed by a specialist trained seniortransplant nurse or surgical registrar with overall supervision by aconsultant transplant urologist. All patients were asked to complete apain score questionnaire. Patients were discharged after voiding andgiven a post procedure care leaflet.ResultsTotal stent removals n=102Coloplast (81%) n=83 Removed at other hospitals 2% (n=2)________________________________Pre-procedure UTI rate 18% (n=15) Post-procedure UTI rate (within 2/52) 2% (n=2)_________________________________Pain score – average 2.6 out of 10_________________________________Urological complications – 0Patients excluded from analysis:13 patients underwent a GA removal of PD catheter and stent. 2 patients had their stents removed at time of  kidney explantation (1º non-function). 1 patient received a magnetic stent.DiscussionThis novel approach to stent removals is preferable to day case surgery procedures. The technique isassociated with less infections, pain and easier access to service thereby reducing waiting times and improvingpatient experience. Monetary savings are observed on equipment sterilization, appropriate use of theatre slotsand staff costs. Finally, it provides an ideal setting for training both nursing and medical staff for minorprocedures. Limitations to the equipment includes the restricted range of movement of the scope (cannotperform full J-manouvre) and therefore may not be used for diagnostic purposes.

Removing transplant ureteric stents using the Coloplast Isiris disposable flexible cystoscope and portable monitor

https://discovery.ucl.ac.uk/10098425/2/Motallebzadeh_BTS%20Poster%20-%20stent%20final%20version_Asia.pdf

Removing transplant ureteric stents using the Coloplast Isiris disposable flexible cystoscope and portable monitor

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