Application of the three-guidewire technique in retrograde stent placement for mucosal sleeve avulsion of the lower ureter
10.12483/j.issn.1009-8291.2026.02.012
- VernacularTitle:三导丝法逆行支架置入术在输尿管下段黏膜袖套样撕脱中的应用
- Author:
Hongchao DONG
1
;
Yu HAO
1
;
Zhao NI
1
;
Qinzhang WANG
1
Author Information
1. Department of Urology, The First Affiliated Hospital of Shihezi University, Shihezi 832008, China
- Publication Type:Journal Article
- Keywords:
surgical technique;
ureteral injury;
ureteral mucosal sleeve avulsion;
catheterization;
ureteroscope;
ureteral stricture;
three-guidewire technique
- From:
Journal of Modern Urology
2026;31(2):163-167
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the feasibility and efficacy of the three-guidewire technique for retrograde stent placement in the treatment of ureteral mucosal sleeve avulsion (UMSA). Methods A retrospective analysis was conducted on the clinical data of 12 patients with UMSA secondary to ureteroscopic lithotripsy for ureteral calculi in our hospital during Jul. 2010 and Oct. 2023. The three-guidewire technique was employed for retrograde stent placement during the procedure. A secondary ureteroscopic lithotripsy was performed one month postoperatively.Results Double-J stent was successfully placed in all 12 patients, with a mean stent insertion time of 23.3(16-30)minutes. No intraoperative exacerbation of mucosal avulsion occurred. One patient was lost to follow-up. At the one-month postoperative ureteroscopic examination and lithotripsy, 81.8% (9/11) cases exhibited unobstructed ureters, while 18.2%(2/11) developed annular membranous strictures, which were resolved following dilation. During subsequent follow-up, the postoperative creatinine level after double-J stent removal showed a mild decrease compared to the preoperative level [87.9(72-100)μmol/L vs. 90.1(69-108)μmol/L]. Up to 90.9%(10/11) patients remained free of hydronephrosis, with only 1 case (9.1%) requiring laparoscopic ureterovesical reimplantation for hydronephrosis 4 months postoperatively. Conclusion The three-guidewire technique for retrograde stent placement in the treatment of UMSA demonstrates strong operability, high success rates, favorable outcomes, and a low incidence of ureteral stricture, which warrant wide clinical promotion.
