Cystoscopic ureteral stent placement: techniques and tips


Introduction and hypothesis

We present a video demonstrating technical considerations and tips for cystoscopic placement of external, lighted, and internal ureteral stents.


Cystoscopic ureteral stent placement is useful in cases where difficult pelvic periureter dissection is expected or encountered. In this video, we review cystoscopy basics, our approach to various types of retrograde stent placement, and performing retrograde pyelograms. Traditional external ureteral stent and lighted stent placement for prophylactic purposes are discussed, with attention to understanding stent markings, appropriate resistance, and steps for externalization. Internal, double-J ureteral stent placement with the use of fluoroscopy is initiated with placement of a guidewire. An open-ended ureteral catheter is advanced over the wire in the pelvic portion of the ureter, and a retrograde pyelogram is performed. The wire is reintroduced and the stent advanced to the renal pelvis under fluoroscopy. The proximal curl is confirmed to be in the appropriate position with fluoroscopy. The string attached to the stent is then cut and removed, the guidewire is removed, and the stent is deployed with the distal curl in the bladder.


This video reviews key steps for cystoscopic ureteral stent placement in a prophylactic setting, cases of challenging anatomy, or ureteral injury.

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  1. 1.

    Drake MJ, Noble JG. Ureteric trauma in gynecologic surgery. Int Urogynecol J Pelvic Floor Dysfunct. 1998;9:108.

    CAS  Article  Google Scholar 

  2. 2.

    Manoucheri E, Cohen SL, Sandberg EM, et al. Ureteral injury in laparoscopic gynecologic surgery. Rev Obstet Gynecol. 2012;5:106.

    PubMed  PubMed Central  Google Scholar 

  3. 3.

    Chou MT, Wang CJ, Lien RC. Prophylactic ureteral catheterization in gynecologic surgery: a 12-year randomized trial in a community hospital. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20:689.

    Article  Google Scholar 

  4. 4.

    Delacroix SE Jr, Winters JC. Urinary tract injures: recognition and management. Clin Colon Rectal Surg. 2010;23:104.

    Article  Google Scholar 

  5. 5.

    Morey AF, Brandes S, Dugi DD III, et al. Urotrauma: AUA guideline. J Urol. 2014;192:327.

    Article  Google Scholar 

  6. 6.

    Al-Kandari AM, Al-Shaiji TF, Shaaban H, et al. Effects of proximal and distal ends of double-J ureteral stent position on postprocedural symptoms and quality of life: a randomized clinical trial. J Endourol. 2007;21:698.

    Article  Google Scholar 

  7. 7.

    Barrett K, Foell K, Lantz A, et al. Best stent length predicted by simple CT measurement rather than patient height. J Endourol. 2016;30:1029.

    Article  Google Scholar 

  8. 8.

    Kawahara T, Ito H, Terao H, et al. Which is the best method to estimate the actual ureteral length in patients undergoing ureteral stent placement? Int J Urol. 2012;19:634.

    Article  Google Scholar 

  9. 9.

    Pilcher JM, Patel U. Choosing the correct length of ureteric stent: a formula based on the patient’s height compared with direct ureteric measurement. Clin Radiol. 2002;57:59.

    CAS  Article  Google Scholar 

  10. 10.

    Erturk E, Sessions A, Joseph JV. Impact of ureteral stent diameter on symptoms and tolerability. J Endourol. 2003;17:59.

    Article  Google Scholar 

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Correspondence to Brian J. Linder.

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Linder, B.J., Occhino, J.A. Cystoscopic ureteral stent placement: techniques and tips. Int Urogynecol J 30, 163–165 (2019).

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  • Cystoscopy
  • Ureteral stent
  • Retrograde pyelogram
  • Ureteral injury