Ureteric stent on string patient self-extraction: an effective and safe method of stent removal during and after the Covid-19 pandemic.
BAUS ePoster online library. Scrimgeour G. 06/22/21; 319129; p9-10
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Ms. Gemma Scrimgeour
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Abstract
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Introduction
Traditional ureteric stent practice involves patients attending the hospital for stent removal. Our aim was to empower patients to remove their stent at home, obviating the need for a hospital visit and flexible cystoscopy, thereby reducing the risk of contracting Covid-19 for both staff and patients.
Patients and Methods
Between March 2020 and January 2021 all patients undergoing ureteroscopic procedures were consented for a possible stent on string (SOS) if clinically appropriate. Verbal and written instructions were provided to enable patients to remove their stent at home. Prospective records were collected including patient and stone demographics, stent dwell time, complications and patient reported outcome measures including pain scores, satisfaction and whether they would consider a SOS in future.
Results
45 patients had a SOS inserted. 40/45 (89%) had stone disease: 27% renal, 20% proximal, 9% mid- and 33% distal ureter. 17/45 (38%) were pre-stented. Mean stent dwell time was 4 days (range 1-6 days). 30/45 (66%) patients removed their own stent at home without complication. The remainder were removed by healthcare professionals for a variety of reasons: 7 patient anxiety, 3 in-patients, 3 attended A&E with stent symptoms, 2 complete migration.
Median pain score was 3.5/10, with 50% reporting it was better than a cystoscopic removal and 89% rating removal as easy.
Conclusions
Empowering patients to self-extract their own stent is effective and safe for the majority of patients. Clear written and verbal communication and telephone follow-up on the day of stent removal are paramount to facilitate this.
Traditional ureteric stent practice involves patients attending the hospital for stent removal. Our aim was to empower patients to remove their stent at home, obviating the need for a hospital visit and flexible cystoscopy, thereby reducing the risk of contracting Covid-19 for both staff and patients.
Patients and Methods
Between March 2020 and January 2021 all patients undergoing ureteroscopic procedures were consented for a possible stent on string (SOS) if clinically appropriate. Verbal and written instructions were provided to enable patients to remove their stent at home. Prospective records were collected including patient and stone demographics, stent dwell time, complications and patient reported outcome measures including pain scores, satisfaction and whether they would consider a SOS in future.
Results
45 patients had a SOS inserted. 40/45 (89%) had stone disease: 27% renal, 20% proximal, 9% mid- and 33% distal ureter. 17/45 (38%) were pre-stented. Mean stent dwell time was 4 days (range 1-6 days). 30/45 (66%) patients removed their own stent at home without complication. The remainder were removed by healthcare professionals for a variety of reasons: 7 patient anxiety, 3 in-patients, 3 attended A&E with stent symptoms, 2 complete migration.
Median pain score was 3.5/10, with 50% reporting it was better than a cystoscopic removal and 89% rating removal as easy.
Conclusions
Empowering patients to self-extract their own stent is effective and safe for the majority of patients. Clear written and verbal communication and telephone follow-up on the day of stent removal are paramount to facilitate this.
Introduction
Traditional ureteric stent practice involves patients attending the hospital for stent removal. Our aim was to empower patients to remove their stent at home, obviating the need for a hospital visit and flexible cystoscopy, thereby reducing the risk of contracting Covid-19 for both staff and patients.
Patients and Methods
Between March 2020 and January 2021 all patients undergoing ureteroscopic procedures were consented for a possible stent on string (SOS) if clinically appropriate. Verbal and written instructions were provided to enable patients to remove their stent at home. Prospective records were collected including patient and stone demographics, stent dwell time, complications and patient reported outcome measures including pain scores, satisfaction and whether they would consider a SOS in future.
Results
45 patients had a SOS inserted. 40/45 (89%) had stone disease: 27% renal, 20% proximal, 9% mid- and 33% distal ureter. 17/45 (38%) were pre-stented. Mean stent dwell time was 4 days (range 1-6 days). 30/45 (66%) patients removed their own stent at home without complication. The remainder were removed by healthcare professionals for a variety of reasons: 7 patient anxiety, 3 in-patients, 3 attended A&E with stent symptoms, 2 complete migration.
Median pain score was 3.5/10, with 50% reporting it was better than a cystoscopic removal and 89% rating removal as easy.
Conclusions
Empowering patients to self-extract their own stent is effective and safe for the majority of patients. Clear written and verbal communication and telephone follow-up on the day of stent removal are paramount to facilitate this.
Traditional ureteric stent practice involves patients attending the hospital for stent removal. Our aim was to empower patients to remove their stent at home, obviating the need for a hospital visit and flexible cystoscopy, thereby reducing the risk of contracting Covid-19 for both staff and patients.
Patients and Methods
Between March 2020 and January 2021 all patients undergoing ureteroscopic procedures were consented for a possible stent on string (SOS) if clinically appropriate. Verbal and written instructions were provided to enable patients to remove their stent at home. Prospective records were collected including patient and stone demographics, stent dwell time, complications and patient reported outcome measures including pain scores, satisfaction and whether they would consider a SOS in future.
Results
45 patients had a SOS inserted. 40/45 (89%) had stone disease: 27% renal, 20% proximal, 9% mid- and 33% distal ureter. 17/45 (38%) were pre-stented. Mean stent dwell time was 4 days (range 1-6 days). 30/45 (66%) patients removed their own stent at home without complication. The remainder were removed by healthcare professionals for a variety of reasons: 7 patient anxiety, 3 in-patients, 3 attended A&E with stent symptoms, 2 complete migration.
Median pain score was 3.5/10, with 50% reporting it was better than a cystoscopic removal and 89% rating removal as easy.
Conclusions
Empowering patients to self-extract their own stent is effective and safe for the majority of patients. Clear written and verbal communication and telephone follow-up on the day of stent removal are paramount to facilitate this.
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