Open Access

ARTICLE

Feasibility and clinical outcomes of ureteral stenting in the office procedural suite

Karen M. Doersch¹, G. Luke Machen², Kim H. Thai², John Sung², Marawan M. El Tayeb²

1 MD/PhD Program, Texas A & M Health Science Center College of Medicine, Temple, Texas, USA
2 Division of Urology, Department of Surgery, Baylor Scott and White Health, Temple, Texas, USA
Address correspondence to Dr. Kim Thai, Division of Urology, Department of Surgery, Baylor Scott and White Health, 2401 S. 31st Street, MS-29-C269, Temple, TX 76502 USA

Canadian Journal of Urology 2018, 25(6), 9596-9600.

Abstract

Introduction: Stent placement is a common procedure for addressing obstructive uropathy. However, lack of operating room (OR) availability can substantially delay this procedure. In this study, we sought to assess the feasibility, safety, and efficacy of this procedure in a clinical setting using nitrous oxide (N₂O) and local anesthesia.
Materials and methods: Patients included in this study included those who were determined to need management of urinary obstruction with a JJ (“double J”) stent and had their procedure performed in the clinic procedure suite with N₂O anesthesia.
Results: We present a case series of 565 patients undergoing ureteral stent placements in a clinic operative suite with N₂O. In this cohort, complications occurred after 4.1% of procedures and unplanned admissions to the hospital occurred after 2.5% of procedures. Stent placements failed in 1.0% of procedures. Failures occurred due to pain in 2/565 patients. No anesthetic complications were encountered.
Conclusion: We report the feasibility and clinical outcomes of ureteral stent placements for ureteral obstruction in a clinic setting with the use of local anesthetic or N₂O anesthesia, with excellent results. A majority of patients tolerated the procedure well and only 2 of 565 had their procedures stopped due to discomfort. To our knowledge, this is the first report of the use of N₂O anesthetic for conscious sedation for the placement of ureteral stents.

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