Pigtail-pigtail with ureteric stent
In case of intercurrent existence of an ureteric stent, the nephrostomy removal should be done in fluoroscopy or ultrasonography to ensure the ureteric stent is not pulled out together with the nephrostomy. If a pigtail nephrostomy is entangled within a pigtail nephrostomy, a stiff wire such as Amplatz can be advanced through the nephrostomy to straighten it out while pulling.
The ureteric stent should be observed until the entire nephrostomy is visible outside the skin, because there may be attachments that are invisible to imaging.
If the ureteric stent happens to follow the nephrostomy, a hydrophilic guidewire may be inserted into it, into the urinary bladder, allowing for insertion of a new ureteric stent.
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