Supplies

• 19 or 22 Fr cystoscope
• 5 Fr open ended catheter x 2
• Wire (sensor straight tip)
• 0 silk
• Special Foley drainage bag where stents can plug in
• 16 Fr Foley

1. Cysto
2. Load 5 Fr open ended and wire into nipple
3. Advance open ended up to the UO, and put up wire
4. Advance open ended into the UO, up til about the 25 cm mark (depending on height)
5. Remove wire
6. Push-pull stent out of scope
7. Re-enter urethra alongside stent, and repeat on other side - both stents should be about the same length at the end
8. Snip the Left stent at an angle, so that the Right stent is at a Right angle
9. Insert Foley, make sure to pull all the way out (and that stents don't move)
10. Cut the end off of the small plug in the drainage bag
11. Tie stents to Foley

Supplies

• 19 or 22 Fr cystoscope
• 5 Fr open ended catheter x 1
• Wire (sensor straight tip)
• 6 Fr stent (length - see above)
• 16 Fr Foley

1. Cysto
2. Collect urine culture
3. Load 5 Fr open ended and wire into nipple
4. Advance open ended up to the UO, use wire to put open ended just past UO
5. Shoot retrograde pyelogram
6. Put wire up
7. Prepare stent - leave long strings if you want patient to be able to pull it out or do it in clinic without cysto, or cut strings off (nidus for infection). Can leave short strings if worried about losing stent up ureter
8. Remove open-ended, thread on stent and push almost past the nipple
9. *Under fluoro, use pusher until metal end of pusher is at middle of pubic symphysis, then pull wire
10. *Under cysto, use pusher until large black mark on stent is just visible - then pull back to bladder neck and gently advance pusher until it is visible, then pull wire
11. Look one more time to make sure stent in place

Supplies

• 19 or 22 Fr cystoscope
• 5 Fr open ended catheter x 1
• Wire x 2 (eg sensor + glide/zip)
• Dual lumen catheter
• Access sheath (12/14 Fr vs 11/13 Fr, 36 vs 45 cm)
• Usually prefer 12/14 sheath
• Flexible cystoscope
• Semirigid cystoscope
• Laser fiber - 200 μm for flexible, 400 μm can fit in semirigid
• 6 Fr stent (length - see above)

1. Cysto
2. Put wire up +/- assistance of open ended catheter
1. If preexisting stent, pull to meatus and put the wire up through that
3. Using dual lumen catheter, put second wire (safety wire) up
1. Don't need to fluoro as much putting this up; less dangerous than access sheath
4. If stone in ureter - can try to access with semirigid (can usually get past iliac vessels, sometimes all the way up to kidney in female)
1. semirigid goes over the 'rails' of the two wires; can sometimes go w/ just one wire
5. Otherwise use flexible cystoscope
6. Generally want to place access sheath over a wire (go slowly and fluoro)
7. Laser laser laser, basket basket basket
8. Stent