The antegrade approach with fluoroscopic guidance is an alternative management strategy for stents management. Compared to the retrograde approach with cystoscopy, it involves a significantly different technique and indication, but both of them are equally effective and safety. The aim of this paper is to report a series of cases with the use of antegrade approach to remove, exchange or insert ureteral stent.

We describe a retrospective series of cases followed up at our institution, utilizing the antegrade approach under fluoroscopic guidance for ureteral stent insertion, removal or exchange.

A total of 4 patients were included (1 male and 3 females), who undergo the intervention of the antegrade approach with fluoroscopic guidance. In each case, several underlying disease, indications and clinical findings were mentioned to prescribe the antegrade approach, such as failure of retrograde approach, previous operation site anastomosis, ureter stent encrustation. In our cases, neo bladder reconstruction and ureteral stricture might be more indicated to the antegrade approach. Some of them was done by urologist, and the other was done by the radiologist. No matter which condition, all of the patient had completed the intervention under fluoroscopic smoothly. During the whole intervention and later follow up period, there was no major complication noted.

Antegrade stent approach with fluoroscopic guidance is a safe and effective alternative management for patients who failure to receive retrograde way or other specific conditions. With non-inferiority complication rates and successful outcomes, this technique solves parts of challenges in managing ureteral double J stents, then offering urologists a valuable option for improving patient care and overall results to those who fail or intolerable to receive retrograde approach.