Abstract
The authors appreciate the supplemental points highlighted in this Letter to the Editor concerning migrated stents; however, we do not think that these are necessarily applicable to our article that addressed a proximally displaced stent during placement in a remote setting. In this scenario, the stent is usually located in the intramural ureter and not advanced into the extravesicle portion. Furthermore, unless recycling previously used stents, we doubt instantaneous debris blockage inhibiting wire passage.
In considering all possible scenarios where this method may be more difficult, we hypothesized that a dilated ureter and/or higher coil strength stents may be more likely to bend or curl, making the technique less successful.
We acknowledge that transferring the patient to a center with ureteroscopic capabilities is always an option; however, in our opinion, attempting this technique does not expose the patient to risk, occupies minimal time, is independent of special baskets/equipment, and may prevent a delay in treatment.
We modestly credit our initial findings to a “fortuitous bounce”; however, we have since helped a colleague reposition a stent using a similar method.
We share our experience to stimulate exploration beyond yesterday's thoughts.