Sami E Majdalany1, Ali H Aldoukhi1, Helene Jung2, Rohit Mehra3, William W Roberts4, Khurshid R Ghani5. 1. Division of Endourology, Department of Urology, University of Michigan, Ann Arbor, MI. 2. Department of Urology, Urological Research Center, Lillebaelt Hospital, University of Southern Denmark, Vejle, Denmark. 3. Department of Pathology, Michigan Center for Translational Pathology, Michigan Medicine, University of Michigan, MI. 4. Division of Endourology, Department of Urology, University of Michigan, Ann Arbor, MI; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI. 5. Division of Endourology, Department of Urology, University of Michigan, Ann Arbor, MI. Electronic address: kghani@med.umich.edu.
Abstract
OBJECTIVE: To compare pressure, dilation, and histology in a porcine model after stenting with a pigtail suture stent (PSS)-where the ureteral and bladder component consists of a suture and a double J (DJ) stent. METHODS: Twelve pigs were studied with a PSS (4.8F/MiniJFil®) and DJ stent (4.8F/RocaJJ Soft) inserted in both sides, except in one where the DJ was not placed to serve as control. Intrapelvic pressure (IPP) and ureteral pressures were recorded. Five pigs were stented for 7 days, and the next 7 for 13-15 days, where a retrograde study was performed after stent removal. Ureteral histology in 4 and 3 pigs stented for 7- and 13-15 days, respectively, were assessed in a blinded manner. RESULTS: In total, 11 renal units were stented with PSS and DJ, respectively. There was a rise in IPP and ureteral pressure after stenting. There were no significant differences in post-stenting pressures between DJ and PSS systems. Ureteral dilation occurred in 100% of DJ and 83% of PSS units. PSS suture migration occurred in 3 of 11. Gross edema at the ureteral orifice was greater with the DJ compared to the PSS (82% vs 18%; p = .003). Histology demonstrated greater inflammation at the ureteral orifice in the DJ group (2.3 vs 1; p = .016) when stented for 13-15 days. CONCLUSION: There was no difference in IPP after stenting with a PSS compared to a DJ stent. When stented for 13-15 days, the PSS resulted in ureteral dilation, but with less edema and inflammation at the ureteral orifice.
OBJECTIVE: To compare pressure, dilation, and histology in a porcine model after stenting with a pigtail suture stent (PSS)-where the ureteral and bladder component consists of a suture and a double J (DJ) stent. METHODS: Twelve pigs were studied with a PSS (4.8F/MiniJFil®) and DJ stent (4.8F/RocaJJ Soft) inserted in both sides, except in one where the DJ was not placed to serve as control. Intrapelvic pressure (IPP) and ureteral pressures were recorded. Five pigs were stented for 7 days, and the next 7 for 13-15 days, where a retrograde study was performed after stent removal. Ureteral histology in 4 and 3 pigs stented for 7- and 13-15 days, respectively, were assessed in a blinded manner. RESULTS: In total, 11 renal units were stented with PSS and DJ, respectively. There was a rise in IPP and ureteral pressure after stenting. There were no significant differences in post-stenting pressures between DJ and PSS systems. Ureteral dilation occurred in 100% of DJ and 83% of PSS units. PSS suture migration occurred in 3 of 11. Gross edema at the ureteral orifice was greater with the DJ compared to the PSS (82% vs 18%; p = .003). Histology demonstrated greater inflammation at the ureteral orifice in the DJ group (2.3 vs 1; p = .016) when stented for 13-15 days. CONCLUSION: There was no difference in IPP after stenting with a PSS compared to a DJ stent. When stented for 13-15 days, the PSS resulted in ureteral dilation, but with less edema and inflammation at the ureteral orifice.