Stenting severely obstructed ureters: a useful method for a common challenge.

In this paper we describe a surgical technique for achieving safe ureteral stent placement in cases of severe obstruction. Although retrograde endoscopic stenting is often the preferred method for ureteral drainage, the existing literature offers limited insight into innovative surgical methods made possible by recent technological advancements. In this report, we present a method that employs a ureteral dilator as an anchor to facilitate precise and effective stent insertion. The technique involves positioning a ureteral dilator in close contact with the tip of the obstructing stone. In this position, the dilator not only functions to dilate the ureter but also serves as a stable anchor point, facilitating the passage of the ureteral stent. We successfully employed this method in 23 patients in whom initial attempts at safe stent placement were unsuccessful due to severe obstruction. In all cases, ureteral drainage was achieved, thus avoiding percutaneous nephrostomy. Our findings suggest that the tensile strength of the ureteral dilator provides reliable anchorage, supporting the advancement of the stent. This technique may offer a safe and effective alternative for ureteral stenting in cases of severe obstruction, potentially reducing the need for percutaneous nephrostomy.