Abstract: Objective To explore a method of exchanging double-J stent in special cases(such as the patients with severe cystitis glandularis who are difficult to find ureteral orifice). Methods We retrospectively analyzed twenty patients with ureteral obstruction caused by different causes that all needed to exchange with a total of 25 double-J stents,15 stents on the left sides and 10 stents on the right sides. The original double-J stent was carefully pulled out to the external urethral orifice, then inserted into the renal pelvis along the orifice of the double-J stent, the old double-J stent was pulled out. And then the new double-J stent was placed along the guide wire. Results 24 of 25 double-J stents in 20 patients were inserted successfully without perforation and hemorrhage. There was a complication of bladder mucosal bleeding in one case. Conclusion This method can reduce the difficulty of intubation and ensure success.

Key words: difficult cases, ureteral orifice, double-J tube, replacement