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Take the Ureteral Stent Placement Knowledge Test

Assess Your Ureteric Stent Procedure Knowledge

Difficulty: Moderate
Questions: 20
Learning OutcomesStudy Material
Colorful paper art depicting a quiz on Ureteral Stent Placement Knowledge Test

Welcome to the Ureteral Stent Placement Knowledge Test, a hands-on urology quiz designed for clinicians and trainees. This stent placement quiz challenges your understanding of indications, techniques, and complication management. Ideal for urology residents, nurses, and medical students aiming to refine procedural skills. Customize it freely in our editor, and explore related Placement Assessment Quiz or ECG Lead Placement Knowledge Assessment. Check out more quizzes to sharpen your clinical expertise.

Which of the following is the primary indication for ureteral stent placement?
Management of urinary incontinence
Relief of ureteral obstruction
Dissolution of kidney stones
Treatment of bladder cancer
Ureteral stents are primarily used to bypass obstructions in the ureter, enabling urine drainage from the kidney to the bladder. They are not designed to treat incontinence, dissolve stones, or target bladder cancer.
Which of the following is a contraindication to ureteral stent placement?
Non-obstructive renal cyst
Mild proteinuria
Controlled hypertension
Uncorrected coagulopathy
Uncorrected coagulopathy increases the risk of bleeding complications during stent insertion. Conditions like mild proteinuria or controlled hypertension do not preclude stent placement.
What is the most commonly used type of ureteral stent?
Nephrostomy tube
Foley catheter
Single-J stent
Double-J stent
The double-J stent, named for its curl at both ends, is the standard for internal ureteral drainage. Nephrostomy tubes and Foley catheters serve different functions.
What is the most commonly used French (Fr) size for ureteral stents?
6 Fr
5 Fr
10 Fr
4.7 Fr
A 6 French size is most commonly selected because it balances drainage capacity with patient comfort. Larger sizes may cause more bladder irritation.
Which imaging modality is most commonly used to confirm proper ureteral stent placement post-procedure?
Computed tomography
Plain radiograph (KUB)
Magnetic resonance imaging
Ultrasound
A plain radiograph of the kidneys, ureters, and bladder (KUB) reliably shows the radiopaque coils of the stent. CT and MRI are not routinely used for initial confirmation.
What advantage does a hydrogel-coated ureteral stent have over an uncoated stent?
Increases risk of infection
Reduces friction and encrustation
Prevents migration entirely
Shortens stent dwell time
Hydrogel coatings reduce surface friction during insertion and may slow encrustation formation. They do not completely eliminate migration or infection risk.
In patients with malignant ureteral obstruction requiring long-term drainage, which stent type is preferred for maintaining patency?
Standard polymer double-J stent
Silicone nephrostomy tube
Self-expanding metallic stent
Single-J external stent
Self-expanding metallic stents exert continuous outward force to maintain patency in malignant extrinsic compressions. Standard polymer stents may collapse under heavy tumor pressure.
When is an antegrade ureteral stent placement approach indicated over a retrograde approach?
When the patient has no hydronephrosis
After failed cystoscopic retrograde access
In all pediatric cases
For right-sided stents only
An antegrade approach via a nephrostomy tract is selected when a retrograde cystoscopic access fails. It is not routine for all pediatric cases or non-obstructed ureters.
Which of the following is the primary risk factor for ureteral stent encrustation?
Prolonged indwelling time
Patient age under 20
Prior stent migration
Low urinary pH only
The longer a stent remains in place, the more mineral deposits can accumulate, leading to encrustation. Younger age or prior migration are not primary drivers.
To reduce the risk of bacteremia during stent placement, what is the recommended prophylactic measure?
Use of cephalosporin-infused stent
No antibiotics unless fever develops
Single dose of fluoroquinolone before insertion
Start three weeks of steroids
A single pre-procedure dose of a fluoroquinolone has been shown to reduce bacteremia risk during urinary tract instrumentation. Extended steroid use is not indicated.
Which imaging technique is best for accurately measuring the required length of a ureteral stent prior to placement?
Retrograde pyelography
Non-contrast CT scan
MRI urography
Renal ultrasound
Retrograde pyelography directly visualizes ureteral length under fluoroscopy, allowing precise stent sizing. Non-contrast CT or ultrasound do not provide continuous ureteral length measurements.
Which combination of symptoms is most indicative of ureteral stent syndrome?
Fever and chills exclusively
Hematuria only
Constipation and back pain
Urinary frequency, urgency, and flank pain
Ureteral stent syndrome commonly presents with lower urinary tract symptoms such as frequency and urgency, often accompanied by flank discomfort. Hematuria alone is less specific.
What is the recommended maximum indwelling time for a standard polymer ureteral stent to minimize complications?
One year
Three months
Six weeks only
One month
Exchanging polymer ureteral stents every three months minimizes risks of encrustation and infection. Longer intervals increase complication rates.
On plain radiograph, which finding suggests proximal migration of a ureteral stent?
Proximal coil seen in mid-ureter
Full coil in bladder
Distal coil absent from bladder
No stent shadow
When the proximal curl is no longer seated in the renal pelvis and appears in the mid-ureter on a KUB, it indicates upward migration. Missing the distal coil suggests downward migration.
How does increasing the internal luminal diameter of a ureteral stent affect stent function?
Prevents need for exchange
Speeds up encrustation
Increases pain and irritation
Reduces risk of occlusion and improves drainage
A larger luminal diameter facilitates greater urine flow, reducing the chance of obstruction. It does not necessarily prevent the need for future exchanges.
What material property of nickel-titanium (Nitinol) makes metallic ureteral stents resistant to external compression?
Rigidity like stainless steel
Hydrophilic surface
High friction coefficient
Shape memory and continuous radial force
Nickel-titanium (Nitinol) stents leverage shape memory to exert constant radial force against external compression. Metals like stainless steel lack this self-expanding property.
What is the optimal management strategy for a ureteral stent heavily encrusted at both ends requiring removal?
Combined ureteroscopic laser lithotripsy and percutaneous extraction
Wait for spontaneous passage
Intravenous hydration only
Simple traction removal
Combined ureteroscopic laser lithotripsy and percutaneous extraction allows fragmenting encrusted material and safe stent removal. Simple traction risks ureteral injury.
How is the appropriate ureteral stent length most accurately determined during a retrograde placement procedure?
Using ultrasound measurement of kidney size
Choosing a standard 26 cm length always
Using fluoroscopic measurement from the PUJ to the UVJ
Estimating based on patient height alone
Fluoroscopic measurement from the pelviureteric junction (PUJ) to the vesicoureteral junction (UVJ) provides the most accurate stent length determination. Patient height alone is too imprecise.
Which radiographic finding would indicate that a ureteral stent has perforated into a vascular structure?
Coil seen within the lumen of the iliac vein on CT
Stent fracture at mid-ureter
Absence of coil in bladder entirely
Coil visible in renal pelvis on KUB
Intravascular perforation is identified when the stent coil is seen within the iliac vein on contrast CT. Absence of bladder coil does not confirm vascular penetration.
What technique can be used to remove a knotted ureteral stent that cannot be withdrawn cystoscopically?
Leaving the stent until knot dissolves
Percutaneous nephrostomy tract approach to untie or fragment the knot
Administration of muscle relaxants only
Continuous gentle traction until it gives
A percutaneous approach through a nephrostomy tract allows direct manipulation to untie or fragment the knotted stent. Gentle traction risks ureteral avulsion.
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Learning Outcomes

  1. Analyze indications and contraindications for ureteral stent placement.
  2. Identify optimal stent types and sizes based on patient scenarios.
  3. Demonstrate proper insertion technique and post-placement imaging interpretation.
  4. Evaluate potential complications and appropriate management strategies.
  5. Apply anatomical knowledge to stent positioning and patient safety.
  6. Interpret postoperative imaging to confirm correct stent placement.

Cheat Sheet

  1. Primary Indications and Contraindications - Stents swoop in to relieve urinary traffic jams caused by stones, tumors, or strictures, but they're benched if a patient has uncorrected bleeding issues or a contrast dye allergy. Mastering when to play and when to pass ensures top-notch patient care. Read more on Radiopaedia
  2. Stent Materials Breakdown - From flexible silicone and sturdy polyurethane to super-strong metal options, each material brings its own superpowers - metal reigns supreme against malignant squeezes, while silicone offers comfort for longer stays. Picking the right suit for your stent mission boosts success. Read more on Medilib
  3. Size Matters - Stents usually span 4 - 7 French in diameter and 24 - 26 cm in length, but tailoring size to patient anatomy prevents jams and kinks. Choosing the perfect fit keeps urine flowing smoothly like water down a slide. Learn about sizing on Medilib
  4. Step-by-Step Insertion Technique - Nail the basics: position the patient, unleash fluoroscopic vision, then slide your stent until both curls hug the renal pelvis and bladder like old friends. Precision here means fewer do-overs and happier kidneys. Technique details on Medilib
  5. Spotting and Managing Complications - Hematuria, UTIs, and rogue stent migration are party crashers you'll want to evict fast - with timely removal, antibiotics, or stent swaps. Early detection and action keep complications from stealing the show. Complication tips on Medilib
  6. Post-Placement Imaging - A quick fluoroscopy or ultrasound check ensures your stent is in the perfect parking spot, guaranteeing a clear path from kidney to bladder. Think of it as the victory lap after a flawless insertion. Imaging guide on Medilib
  7. Anatomical Precision - Guide that proximal curl into the renal pelvis and let the distal curl rest in the bladder - avoid kinks that could stop the flow and sabotage your hard work. Anatomy knowledge is your trusty GPS in this journey. Anatomy tips on Medilib
  8. Recognizing Patient Red Flags - Persistent flank pain, new-onset hematuria, or odd urinary patterns could signal stent trouble - be ready to investigate and intervene before small issues balloon. Keeping an ear out for patient feedback can save the day. Learn more at Cleveland Clinic
  9. Stent Removal Protocols - Whether you're using a cystoscope or a snare, timing is everything - remove before encrustation becomes a bumpy road and tailor removal to the underlying condition for a smooth exit. Practice makes perfect when it's time to pull the plug. Removal pointers on Medilib
  10. Future-Forward Stent Innovations - Keep your eyes peeled for drug-eluting and biodegradable stents that aim to shrink complications and dial up patient comfort - tomorrow's tech might just make today's challenges a thing of the past. Staying updated keeps you ahead of the curve. Innovation insights on Medilib
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