Ureteroscopy with Double-J (JJ) ureteral stent placement

Ureteroscopy (URS) with Double-J (JJ) Ureteral Stent Placement is a minimally invasive endourological procedure performed through the natural urinary tract, allowing the examination and treatment of ureteral conditions.

The procedure is primarily used to treat ureteral and kidney stones but may also be indicated in other situations requiring evaluation or restoration of upper urinary tract patency.

The ureteroscope is inserted through the urethra and urinary bladder into the ureter without making any skin incisions.

As part of this procedure, ureteroscopy is followed by the placement of a Double-J (JJ) ureteral stent. The stent is temporarily positioned in the ureter between the renal collecting system and the urinary bladder to maintain ureteral patency and ensure urine drainage during the postprocedural period.

The indication for JJ stent placement is determined by the urologist based on the condition being treated, the characteristics of the intervention, and the risk of ureteral obstruction. The duration of stent placement is determined individually, and the stent must be removed or replaced within the timeframe recommended by the physician.

The primary purpose of the procedure is the endoscopic diagnosis and treatment of ureteral conditions, particularly urinary stone disease, while restoring or maintaining normal urine drainage from the kidney to the urinary bladder.

Indications

• Ureteral stones requiring active endoscopic treatment;
• Selected kidney stones suitable for retrograde endoscopic treatment;
• Stones that have not passed spontaneously or for which other treatment methods are not indicated or have proven ineffective;
• Upper urinary tract obstruction associated with urinary stone disease;
• Persistent or recurrent pain caused by urinary stones when active treatment is indicated;
• Impaired urinary drainage or renal function due to stone-related obstruction;
• Situations in which temporary maintenance of ureteral patency and urinary drainage is required following endoscopic treatment.

JJ stent placement during the procedure is used to maintain urinary drainage and ureteral patency, particularly in the presence of ureteral edema or trauma, the risk of postprocedural obstruction, residual stone fragments, ureteral injuries, or other conditions requiring temporary ureteral drainage.

The indication for ureteroscopy with JJ stent placement is determined individually by the urologist, taking into account the location and characteristics of the stones, the degree of obstruction, anatomical features, intraoperative findings, and the patient's clinical condition.

Procedure

The procedure is performed under anesthesia, as recommended by the anesthesiologist.

The ureteroscope is inserted through the urethra and urinary bladder and advanced into the ureter without making any skin incisions.

The physician examines the urinary tract endoscopically and identifies the condition requiring treatment. At the end of the intervention, a Double-J (JJ) ureteral stent is placed. One end is positioned within the renal collecting system and the other within the urinary bladder, allowing urine drainage and maintaining ureteral patency.

After the procedure, the patient is monitored until recovery from anesthesia and receives instructions regarding further care.

Limitations

The temporary presence of a JJ stent may cause frequent urination or urinary urgency, discomfort during urination, suprapubic or lumbar pain, and mild hematuria (blood in the urine). The severity of these symptoms varies between patients.

The JJ stent must be removed or replaced within the timeframe established by the urologist. The duration of placement is individualized and depends on the indication for stenting and the patient's clinical progress.

Contraindications

Contraindications to the procedure are not specified in the text provided by the physician.

Advantages

Temporary JJ stent placement may be necessary to:

• maintain ureteral patency after the intervention;
• ensure urinary drainage;
• prevent or treat obstruction caused by postprocedural edema;
• facilitate urinary drainage in cases of ureteral trauma;
• reduce the consequences of obstruction caused by residual stone fragments;
• support ureteral healing following certain endoscopic procedures.