A simplified method for placement of internal ureteral stents

In the last few years, antegrade percutaneous placement of ureteral stents by the radiologist has been popularized [1 -3]. The most commonly used stent device is the double pigtail catheter, a design of simple elegance [4]. However, technical difficulties in traversing the soft tissues of the back and positioning of the pigtail in the renal pelvis occur commonly. Two refinements in technique that address these problems are described here. First, difficulty in negotiating noncompliant soft tissues and renal parenchyma is greatly decreased by use of a Desilets-Hoffman sheath (Cook). Second, excellent control of the final position of the pigtail in the renal pelvis may be achieved by use of a suture threaded through two side holes in the middle of the proximal pigtail curve.