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From 2016–2023, transurethral removals were attempted in 996 procedures, achieving 99.2% technical success. Multivariable analyses estimate fluoroscopy time decreases with complex snares and increases with simple snares and looped guidewires, while forceps is not significant. Findings support efficient fluoroscopically guided removal with appropriate device selection.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/factors-affecting-the-difficulty-of-transurethral-double-j-stent-removal-in-patients-with-renal-transplants/434691/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/factors-affecting-the-difficulty-of-transurethral-double-j-stent-removal-in-patients-with-renal-transplants/434691.png","ImageObject",300,407,{"name":92,"@type":93},"Putri","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-04","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":24},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the main goal of the study?","Question",{"text":112,"@type":113},"To identify factors affecting the difficulty of transurethral double J (JJ) stent removal in renal transplant patients, using fluoroscopy time as a surrogate for procedural difficulty.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How successful was transurethral JJ stent removal overall?",{"text":117,"@type":113},"Technical success was 99.2% across 996 procedures. The mean fluoroscopy time for successful removals was 4.9 minutes.",{"name":119,"@type":110,"acceptedAnswer":120},"Which devices were associated with changes in fluoroscopy time?",{"text":121,"@type":113},"In multivariable models, complex snares were associated with shorter fluoroscopy time, while simple snares and looped guidewires were associated with longer fluoroscopy time. 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ORIGINAL)[ ORIGINAL](Available online at dirjournal.org. ORIGINAL) ARTICLE  \nContent of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.  \nFactors affecting the difficulty of transurethral double J stent removal in patients with renal transplants  \n Elisabeth R. Seyferth  Gregory J. Nadolski  Jeffrey I. Mondschein  Ryan M. Cobb  \n Scott O. Trerotola  \nDivision of Interventional Radiology, Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, United States of America  \nCorresponding author: Elisabeth R. Seyferth  \nE-mail: [Elisabeth.seyferth@pennmedicine.upenn.edu](Elisabeth.seyferth@pennmedicine.upenn.edu)  \nReceived 12 August 2025; revision requested 08 September 2025; accepted 15 October 2025.  \nPURPOSE  \nThis study aimed to identify factors affecting the difficulty of transurethral double J (JJ) stent removal in patients with renal transplants, using fluoroscopy time as a surrogate for procedural difficulty.  \nMETHODS  \nBetween January 2016 and November 2023, transurethral stent removal was attempted in 996 procedures (342 women, mean age 53.1 years). The following potential predictors offluoroscopy time were investigated using bivariate analysis: patient age, sex, performance of the procedure by an attending physician alone, time from stent placement to removal, configuration and location of stent loop in the bladder, and device used for removal. For each stent retrieval device type, a multivariable model was created, including covariates of interest.  \nRESULTS  \nStent removal was technically successful in 99.2% of procedures. The mean fluoroscopy time for successful removals was 4.9 minutes (range 0.1–39.6 minutes). There were 5 adverse events (5/996, 0.5%), consisting of 3 moderate and 2 mild severity events. A complex snare was used in 72.5% of procedures, a simple snare in 6.0%, a looped guidewire in 31.6%, and forceps in 2.5%; multiple devices were used in 11.9% of procedures. Patient sex, number of intravesicular stent loops, and use of a simple snare, looped guidewire, and forceps predicted fluoroscopy time in bivariate analyses. In multivariable models, mean fluoroscopy time was estimated to be 0.78 minutes less when a complex snare was used (P = 0.018), 1.87 minutes greater when a simple snare was used (P = 0.002), and 0.86 minutes greater when a looped guidewire was used (P = 0.014); the use of forceps was not significant. When procedures using multiple devices were excluded, only the use of a complex snare and looped guidewire remained significant.  \nCONCLUSION  \nTransurethral JJ stent removal has a high success rate and can be performed with a single device in most cases. Use of complex snares and looped guidewires is associated with decreased and increased fluoroscopy time, respectively, suggesting that use of these devices may impact procedural difficulty.  \nCLINICAL SIGNIFICANCE  \nThese results demonstrate that fluoroscopically guided transurethral JJ stent retrieval is an efficient technique that may be offered instead of cystoscopic stent removal. Careful choice of removal device may improve speed and ease of transurethral stent retrieval.  \nKEYWORDS  \nRenal transplantation, renal, double J stent, snare  \nEpub: 12.11.2025  \nPublication date: 02.01.2026  \nDOI: 10.4274/dir.2025.253520  \nYou may cite this article as: Seyferth ER, Nadolski GJ, Mondschein JI, Cobb RM, Trerotola SO. Factors affecting the difficulty of transurethral double J stent removal in patients with renal transplants. Diagn Interv Radiol. 2026;32(1):119-124 .  \n119  \nDouble J (JJ) ureteral stent placement  \nhas become commonplace in renal  \ntransplantation, as data show thatstent placement results in reduced rates of post-operative urinary leakage and ureteral obstruction.1-3 A Cochrane systematic review found that the incidence of major urologic ","cbCaiq1HnIs6hfrh","https://ap.wps.com/l/cbCaiq1HnIs6hfrh","pdf",1129088,"English","# Purpose\n# Methods\n# Results\n# Conclusion\n# Clinical significance\n# Keywords","[{\"question\":\"What was the main goal of the study?\",\"answer\":\"To identify factors affecting the difficulty of transurethral double J (JJ) stent removal in renal transplant patients, using fluoroscopy time as a surrogate for procedural difficulty.\"},{\"question\":\"How successful was transurethral JJ stent removal overall?\",\"answer\":\"Technical success was 99.2% across 996 procedures. The mean fluoroscopy time for successful removals was 4.9 minutes.\"},{\"question\":\"Which devices were associated with changes in fluoroscopy time?\",\"answer\":\"In multivariable models, complex snares were associated with shorter fluoroscopy time, while simple snares and looped guidewires were associated with longer fluoroscopy time. Forceps use was not significant.\"}]","Factors affecting the difficulty of transurethral double J stent removal in patients with renal transplants | PDF",1790670259,15]