Editing Nephrolithiasis (section)

== Cystoscopy and JJ stent ==

* Rigid cystoscopy, and locate the ipsilateral UO
* Pass a guidewire into the ureter, and advance it using II
** Usually get resistance when you reach the stone - keep gently probing until it passes. Sometimes need to use the ureteric catheter at this point for extra stiffness. If unable to get past, a nephrostomy will be required.
** Advance the wire into the renal pelvis, where it will curl
* Pass a 6Fr ureteric catheter over the wire. When it is in the renal pelvis, take the guidewire out, and aspirate some urine for culture through the ureteric catheter. Then switch back to the wire.
* Pass a double J stent (26cm for tall patients, 22cm for short, and 24cm for average) up to the pelvis, using a stent pusher over the wire to get it up 
* Remove the wire completely

[[Category:Urology]]