# Stent Reposition through Stoma, Help!



## RainyDaze (May 1, 2013)

I'm not having any luck with this, I hope someone out there can help me.  Thanks!!

PREOPERATIVE DIAGNOSIS:  Left ureteral stent misplacement
POSTOPERATIVE DIAGNOSIS:  Same.
PROCEDURE: Bilateral retrograde pyelograms, re-positioning of left ureteral stent
EBL: 0cc
Specimens: None

INDICATIONS FOR PROCEDURE: The patient is a 61 year old female who underwent a radical cystectomy yesterday. Today she developed left CVAT and had low UOP. The post-op KUB was suspicious for placement of the stent superior to the left kidney. A CT KUB confirmed that. We present to reposition the sent. Informed consent was given prior to the procedure.

DESCRIPTION OF PROCEDURE: 


A proper time out was performed correctly identifying the patient, surgeon, site of procedure, allergies. The stoma was examined and found dark red-hemorrhagic with urine exuding from the urostomy and both stents. Unable to determine which was the left, I injected one which turned out to the the right stent. A normal RGP was seen and the stent in good position. The left stent was then gently pulled until the internal chromic suture popped and the stent was pulled down to approximately the level of the renal pelvis. A RGP was then performed confirming placement in the upper pole of the collecting system without hydronephrosis and contrast extravasation out the upper pole into the retroperitoneum. She tolerated this well. The stent were replaced into the urostomy bag. She was replaced to the stretcher and taken back to the floor in good condition.


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## RainyDaze (May 6, 2013)

Anyone??


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## Kelly_Mayumi (May 9, 2013)

RainyDaze, this is a difficult procedure, it seems kind of scanty.  I have two questions for you about this, what sort of urinary diversion does the patient have since their bladder was removed.  My other question is, how was the contrast injected?


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