ArticleWorld journal of urology2026
A hybrid model of ureteral stent change - ambulatory cystoscopy suite under local anesthesia versus operating room under general or monitored anesthesia.
Article in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposePatients with long-term ureteral stents need regular change, traditionally under General Anesthesia (GA). We present a hybrid model where patients are risk-stratified for anticipated technical difficulty: (1) local anesthesia (LA) in the outpatient cystoscopy suite as day procedures, or (2) GA/ Monitored Anesthesia Care (MAC) in operating room (OR).
methodsA retrospective review was conducted of ureteral stent changes between 2021 and 2025, using a risk-stratified model: lower-risk as outpatient LA in ambulatory cystoscopy suite, and higher-risk under GA/MAC in the OR.
resultsA total of 569 stent changes were performed: 348 (61%) under LA in cystoscopy suite, and 221 (39%) under GA/MAC in OR. LA cystoscopy suite stent change patients were older (75 vs. 69 years, p < 0.01), with higher ASA grade (ASA 3/4 = 79 vs. 66%, p < 0.01). There were similar proportions of males (43 vs. 48%) and bilateral ureteral stent changes (15 vs. 16%) (all p > 0.05). Under LA, 335 (96.3%) stent changes were successful, compared with 220 (99.5%) in OR (p < 0.05). Complication rates were similar (3.74 vs. 5.45%, p = 0.35), with most complications being urinary tract infections managed conservatively (Clavien 1/2).
conclusionA hybrid ureteral stent change model with selected ureteral stent changes performed under LA in the ambulatory cystoscopy suite instead of the OR, is a feasible and safe option. Advantages include avoiding risks of general anesthesia and reducing the duration of hospital stay as an ambulatory day case. LA stent change has cost-savings, conserves hospital resources and can be considered for older and higher ASA risk patients.
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