PMC10329435_01
Appearance of ureteral stents by X-ray and endoscopy. (A) The patient was fitted with Polaris  Loop stents (Boston Scientific) but acute kidney injury occurred, and stent-related symptoms adversely affected patient comfort. (B) Endoscopic appearance of the ureteral orifice with a Polaris  Loop stent. (C) Loop of Polaris  stent overlapping the bladder neck and causing bladder irritation in this patient. (D) In 2017, the patient was fitted with reinforced pigtail-suture stents. With this design, the bladder loop was replaced with a thin suture thread invisible on X-rays. (E) Ureteral orifice with sutures of the pigtail-suture stent. (F) Sutures of the pigtail-suture stent (arrow) away from the bladder neck, avoiding any conflict with the bladder. (G) In 2021, the pigtail-suture stents were replaced by customized reinforced ureteral stents with an end-piece for sudden ureteral orifice obstructions. The end-piece is invisible on X-rays. (H) End-piece of a customized stent in the ureteral orifice. The orifice obstruction had to be bypassed by a rigid stent segment and not by the suture and the end-piece was embedded at the bottom of the stent to prevent the stent from slipping into the ureter. The customized stent is bound firmly in place to the ureteral orifice, avoiding any conflict with the bladder neck. (I) End-piece of a customized stent and its two side wings. The wings are flexible enough to allow introduction into the urethra.
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Nonetheless, the indwelling stents impaired the quality of life due to stent-related symptoms, despite the use of various stent shapes such as Polaris  Loop stents (Boston Scientific) (Figure 1A-C). To improve the quality of life, the patient was fitted with 8-French pigtail-suture stents, with replacement of the bladder-loops by a thin suture thread (Figure 1D-F). In 2021, the patient was fitted with customized ureteral stents sectioned to the exact length of the ureter, with replacement of the bladder-loops by an end-piece that prevents the stent from slipping off into the ureter (Figure 1G-I).