The Double Wire Technique: An Alternative Method for Difficult Ureteroscopic Access

Abstract

We read with great interest the study report by Ji et al. (Urol Res, doi:10.1007/s00240-012-0476-0, 2012) about the impact of the intentional ureteral stenting on the success rate of calculus extraction by second ureteroscopy, when the initial ureteroscopy failed. Actually, sometimes ureteral stone treatment pose challenging problems for the urologists. This study has Wlled an important gap on this Weld. If Xexible ureteroscopy and laser lithotripter are not available pre-existing stent may improve the success rate of a subsequent ureteroscopy for impacted ureteral stones. Because, post-stent ureteroscopy has the advantage of working through a dilated ureter. We would like to add some additional comments and suggestions in addition to the authors' discussion, which is noteworthy in several respects. In 1.6-2.7 % of cases [2, 3], a ureteroscope Wnds it hard to pass the meatus, to run through the intramural ureter, or to reach the lesion. A reduction in size and improvements in the shape of instruments have rendered such occurrences somewhat rare, however not totally obsolete. When the ureteral oriWce is too narrow to accommodate a ureteroscope, dilation may be accomplished with serial dilators, balloons, or even the ureteroscope itself with the risk of trauma and the potential for long-term stricture formation. © Springer-Verlag 2012.