**4. The Paterson-Forrester stent**

#### **4.1 Equipment**

The Paterson-Forrester 65cm, 8.5F polyurethane stent (Cook Ireland Ltd)

Cystoscopy tray for either (flexible or rigid cystoscopy)

Percutaneous nephrostomy track placement tray with telescopic metal dilators to size 3 (18F).

Contrast solution in a luer lock syringe

Minor operation tray with scalpel, tissue forceps and clips

Dissecting scissors

284 Chronic Kidney Disease

Fig. 2. Tumour invasion along the route of an extra-anatomic stent.

The Paterson-Forrester 65cm, 8.5F polyurethane stent (Cook Ireland Ltd)

Cystoscopy tray for either (flexible or rigid cystoscopy)

2005).

both types of stents.

**4.1 Equipment** 

**4. The Paterson-Forrester stent** 

nephro-vesical subcutaneous urinary diversion. The diameter of the stent is thought to be the main determinant of the duration the stent may remain in situ without encrustation or blocking. It has been estimated that a 17 F diameter is required to prevent stent encrustation irrespective of its composition in association with increased fluid intake (Andonian, et al.

To this end, we utilize two types of stents in our practice. One is a short-term 8.5F 65cm EAS without side holes except at either end. We offer to all patients with malignant disease and in patients with poor general health and benign disease where there is concern regarding the functionality of the bladder. If they survive the first change and have a good prognosis, we will usually discuss conversion to a more long-term 29F Detour EAS. The latter stent requires a more invasive technique including an open cystostomy but has the advantage of potentially being a permanent diversion with a single procedure. We use it as a primary option in patients with a long life expectancy. Below, we describe our technique of inserting Needle holder and absorbable sutures

Nephrostomy needle and 0.38F j tip wire

12 F peel away sheath

0.38F floppy tip stiff core Sensor wire (Microvasive)

*Extra equipment for exchange of stent* 

6F end flushing ureteric catheter

Flexible rat-toothed stent removing forceps if flexible cystoscope is used
