Evaluating the Efficacy and Safety of Patient "Virtual" Self-Removal of Ureteric Stents With Extraction Strings Following Ureterorenoscopy.
Desai, Chaitya Sarmah, Piyush Devarajan, Raghuram
Desai, Chaitya
Sarmah, Piyush
Devarajan, Raghuram
Affiliation
Urology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, GBR.
Other Contributors
Publication date
2025-11-17
Subject
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
INTRODUCTION: Ureterorenoscopy (URS) is commonly followed by ureteric stent placement to maintain drainage and prevent complications. Stents with extraction strings allow for patient self-removal, potentially reducing hospital visits and healthcare costs. We evaluated the safety and efficacy of a self-removal pathway, whereby patients removed their own stent at home and confirmed removal by sending a photograph to their consultant, or respective secretary, via email.
METHODOLOGY: A prospective review was undertaken of all patients who received a ureteric stent with an extraction string after URS at a UK tertiary center between 2016 and 2021. Patients were provided verbal and written instructions, including red-flag symptoms and details of the confirmation process. Data collected included demographics, stone location, stent dwell time, method of removal, complications, and patient feedback.
RESULTS: A total of 112 patients (median age 48.2 years, range 18-86; 46 (41%) were female and 66 (59%) male) met the inclusion criteria. Median stent dwell time was 4 (range 0-10) days. Ninety-nine patients (88.4%) successfully self-removed their stents at home with email confirmation, while 10 patients (8.9%) underwent removal by a healthcare professional. Complications occurred in 9 patients (8.0%), none exceeding Clavien-Dindo grade II. No adverse patient feedback was reported. Compared with published literature, complication rates and stent dislodgement were lower. The practice was associated with significant estimated cost savings by avoiding outpatient cystoscopy.
CONCLUSIONS: Patient self-removal of ureteric stents using extraction strings, with virtual confirmation, is a safe and effective strategy. It minimizes hospital visits, reduces healthcare costs, and empowers patients. Wider adoption of this model could standardize care pathways and support NHS sustainability targets. Further multicenter studies and randomized trials are warranted to validate these findings.
Citation
Cureus . 2025 Nov 17;17(11):e97042.
Type
Article