Authors (including presenting author) :
Leung SY(1)(2), Yung WY(3), Ma KC(4)(2), MK Chan(4)(2), Tsang WMJ(1)(2), Wong LYA(1) (2), Lu YKG(1)(2), Lau SHV(1)(2), Chan KK(1)(2), Tsui YS(1)(2), Chan SC(1)(2), Ho WY(1)(2), Cheng CH(3), Chan YS(3), Li KM(3), Man CW(3), Chu SK(3), Ng T(3)
Affiliation :
(1)Ambulatory Urology Centre, (2)Pok Oi Hospital, (3)NTWC Surgery (Urology), (4)Ambulatory Service Nursing Management
Keyword 1: :
Internal Ureteric Stent
Keyword 2: :
Urology Nursing service
Keyword 3: :
Patient Safety
Keyword 4: :
Waiting Time
Keyword 5: :
Health care financial Outcomes
Introduction :
Traditionally, urologists remove internal ureteric stent(s) by flexible cystoscope under local anesthesia, with waiting times of 8-12 weeks and an estimated cost of HK$400 to HK$1000 per case. To enhance efficiency and patient care, Pok Oi Hospital (POH) launched a new urology nursing service in December 2024 for removal of internal ureteric stents with extraction strings.
Objectives :
(1) To shorten waiting time for stent(s) removal, (2) To lower procedural costs, and (3) reduce stent related complications to improve patients’ quality of life by timely remove stent(s).
Methodology :
We retrospectively reviewed all ureteric stent (with string) removal cases by urology nurses from December 2024 to December 2025. Key outcome measures included: (1) stent(s) dwell time, (2) complications before removal of stent(s), (3) pre- and post stent(s) removal pain scores, (4) scores of ‘Ureteral Stent -Related Symptom Scoring Short Form’ , (5) readmission rate within 1 week after stent(s) removal and (6) estimated cost of stent(s) removal.
Result & Outcome :
A total of 46 patients were reviewed; 58% were male and median age was 60–70 years. The median stent dwell time was 10 days, with average pre- and post-removal pain scores of 2 and 1, respectively. The mean score of ureteral stent related symptom was 11/29. Consumable cost per case was HK$12.21, a significant reduction from the traditional cost of HK$400 -$1000. All appointments were appropriately scheduled within the post-operative plan. Complications included 17% (8) with distal stent migration due to accidental string traction, 2% (1) with self-cut stent extraction string, 2% (1) with string dislodgment during removal requiring cystoscopy retrieval, and 2% (1) with gross hematuria. 8.7% (4) were admitted before their clinic appointments due to stent migration or hematuria. 91.3% (42) attended appointments as scheduled and had their stents removed uneventfully – 95% (40) by nurses, and 5% (2) required ad hoc endoscopic removal of stent due to stent extraction string loss. Readmission rate was 2% (1) after stent removal with suspected ureteric stricture. Conclusions: The new ureteric stent (with string) removal urology nursing service at POH proved safe, efficient, and cost-effective. It markedly reducing clinical cost and waiting time while maintaining patient safety and comfort, supporting ongoing development of nurse-led urological procedures in public hospitals.
