Double-Pigtail Stents for Distal Ureteral Calculi: An Alternative Form of Definitive Treatment

Abstract
In this study, we treated patients with a solitary distal ureteral stone of less than 10 mm in maximum diameter by placing a double-pigtail stent and subsequently removing it allowing the calculus to pass spontaneously. A total of 40 patients were enrolled in the study with a mean stone size of 5.1 x 3.5 mm (range 2-8 mm in length and 2-7 mm in width). The indication for intervention was intractable pain in 5 patients, infection due to obstruction in 2, highly obstructed urinary tract in 10, absence of progression for 30 days in 21 and desire of the patient to be free of stone in 2. A double-pigtail stent was inserted in the involved ureter under local anesthesia and left in place for 2 weeks. After stent removal, 34 patients succeeded in passing the stone within an average time of 5.8 days. The overall success rate was 85%. We suggest this method as an alternative form of treatment for distal ureteral calculi to extracorporeal shockwave lithotripsy of ureterolithotripsy under selected clinical circumstances.