Ureteral stent placement

The ureteral orifice is first identified (A) and cannulated with a guidewire (B). The guidewire is placed beyond the area of obstruction and into the renal pelvis (C). A ureteral access catheter is placed over the guidewire, the guidewire is removed, and contrast is injected to opacify the renal pelvis, aiding accurate stent placement (D). The guidewire is replaced into the renal pelvis through the access catheter, which is then removed (not shown). The red, metal-tipped pusher is used to maneuver the stent over the wire and up the ureter (E). The end of the ureteral stent can be seen at the bladder neck. Finally, the wire is removed and the stent is fully deployed (F). A full pigtail curl should be visualized in the bladder. Fluoroscopy can also be used to verify an adequate curl in the renal pelvis (not shown).