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Antegrade Ureteral Stent Placement

When long-term urinary diversion is needed, an internalized ureteral stent is preferable to a nephrostomy tube and drainage bag. Retrograde insertion of an internal stent is generally attempted first but may be unsuccessful when the ureter is severely stenosed, is markedly tortuous, or has been anastomosed to bowel. With the advances made in flexible ureteroscopy, failure of retrograde stenting is unusual. Consequently, antegrade stenting is now a less common procedure.

Antegrade ureteral stent placement is usually performed in patients who have an existing nephrostomy tube and in whom conversion to internal urinary drainage is desirable.[11-13]The success of stent placement depends on properly chosen access. Percutaneous entry into the midcalyceal group allows for better torque control of the catheter than that into the lower pole calyx. If difficulty is encountered in advancing a stent through a region of stenosis by way of an existing nephrostomy tube …