Live renal ultrasonography facilitates double-J ureteral stent insertion at the bedside: a pilot study for the COVID-19 era.

OBJECTIVES: To investigate the feasibility and efficacy of live renal ultrasonography to guide double-J ureteral stent placement at the bedside. PATIENTS AND METHODS: Between April 12 and June 5, 2020, patients presenting with acute ureteral obstruction requiring decompression were prospectively selected for ultrasound-guided bedside ureteral stent placement. During stent placement, upper tract access confirmed using ultrasound with or without retrograde injection of ultrasound contrast prior to double-J stent insertion. A post-procedural abdominal x-ray was obtained for stent position confirmation. RESULTS: Eight patients (4 men, 4 women) were offered bedside ultrasound-guided ureteral stent placement, and all 8 consented to proceed. Stents were successfully placed in 7 of 8 patients. One patient had an impacted ureterovesical junction stone and stricture requiring ureteroscopy and laser lithotripsy in the operating room. All patients tolerated procedures without immediate complications. CONCLUSION: Live renal ultrasonography can facilitate a high success rate for bedside ureteral stent placement outside the operating room. This approach is an attractive alternative to fluoroscopy-guided stent placement in the operating room and is of particular value in the COVID-19 era when judicious use of these resources is salient.