An unusual complication of a double-J ureteral stent: Renal parenchymal perforation in a solitary kidney

Gonulalan, Umut; Akand, Murat; Hasırcı, Eray; Kosan, Murat

doi:10.5152/tud.2014.76753

Cited by 9 publications

(9 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, the most common was the placement of the proximal end into the ureter, but we also experienced 3 cases with placement into retroperitoneum, one case with parenchymal perforation and hematoma. Renal parenchymal perforation is rare but life-threatening [ 6 ]. A malpositioning complication like intravascular migration of double J stent, ureteroarterial fistula, hemoperitoneum, or knotted stent has been reported as very rare [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Ureteral stent complications – experience on 50,000 procedures

et al. 2021

View full text Add to dashboard Cite

Double J stent is an essential tool in urology, being a basic part of many urological procedures. However, some issues related to their use still occur. Our study aimed to evaluate an important number of procedures, the complications of ureteral stents, and their prevention and treatment retrospectively. We evaluate 50,000 procedures performed between 1996 and 2021 on 36,688 patients. According to the stenting duration, the cases were divided into short-term (less than 6 weeks – 34,213 procedures), respectively long-term stenting (more than 6 weeks – 15,757 procedures). The indications of stenting for both groups were noted. The total number of complications was 41,369. We encountered 153 cases (0.3%) of JJ stent malposition, of which 3 cases were into the retroperitoneum, one case with parenchymal perforation and hematoma. Considering the double J migrations, we found proximal migration in 427 cases (0.9%) and distal double J migrations in 352 (0.7%) cases. The obstruction of the ureteral stent, causing inefficient drainage, was encountered in 925 cases, while irritative bladder symptoms occurred in 16,326 cases (32.7%). Hematuria was observed in 5,213 cases, in 7 cases blood transfusion being nec-essary. Urinary tract infection was diagnosed in 7,436 cases (14.8%). Stent encrustation and calcification occurred in 832 cases, while stent fragmentation was noted in 52 cases. Double J stent complications should be promptly evaluated and treated. Encrustation and stone formation in forgotten stents often lead to serious complications and should be managed with stent removal and combined endourological techniques.

show abstract

Section: Discussionmentioning

confidence: 99%

Ureteral stent complications – experience on 50,000 procedures

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Some reports note the development of a subcapsular hematoma developing after a double-J stent placement [ 7 , 8 ]. Other reports noted the development of a perinephric hematoma following renal parenchyma perforation or forniceal rupture from an obstructive ureteral calculus [ 9 , 10 ]. To our knowledge, there are no cases of isolated perinephric hematomas developing after double-J ureteral stent placements.…”

Section: Discussionmentioning

confidence: 99%

Perinephric Hematoma Associated with Pyelonephritis Following Ureteral Stent Placement for Ureteral Obstruction Causing Hydronephrosis

Chung

Bhagia

2021

Am J Case Rep

View full text Add to dashboard Cite

Patient: Female, 43-year-old Final Diagnosis: Perinephric hematoma Symptoms: Chills • fever • flank pain Medication: — Clinical Procedure: — Specialty: General and Internal Medicine Objective: Rare co-existance of disease or pathology Background: Perinephric hematomas are rare, especially following ureteral stent placement. Etiologies of perinephric hematomas include post-extracorporeal shockwave lithotripsy, Wunderlich syndrome, and renal cell carcinoma, none of which occurred in our patient, who underwent stent replacement. Subcapsular renal hematoma, rather than a perinephric hematoma, can occur following double-J ureteral stent placement. Also, renal parenchymal perforation leading to perinephric hematoma development are complications of double-J ureteral stent placement. Herein, we present a case of a perinephric hematoma following a double-J ureteral stent placement for a ureteral obstruction causing hydronephrosis. Case Report: A 43-year-old woman with type 2 diabetes mellitus, hypertension, systemic lupus erythematosus, and recurrent nephrolithiasis presented to our hospital with left flank pain of a 1-day duration. The patient was found to have an obstructive kidney stone causing hydronephrosis. She underwent stent placement and then developed a perinephric hematoma days later. Typically, hematomas are treated conservatively and have spontaneous resolution. The patient received 2 weeks of intravenous antibiotics and 2 more weeks of oral antibiotics, and failed conservative treatment. She re-presented to our hospital 3 days after discharge. Upon the second admission, a perinephric drain was placed. The patient was given another course of antibiotics and was discharged 18 days later. Conclusions: A perinephric hematoma is a rare complication after ureteral stent placement. Perinephric hematoma development can be decreased by controlling blood pressure, treating preoperative urinary tract infections, and shortening operating time during ureteroscopy. It is important to reevaluate potential causes of continued abdominal pain with laboratory testing and repeat imaging.

show abstract

“… 1 They usually present with a urinoma or hematoma. 1 , 3 Although ureteral double J stenting is a safe procedure, serious complications requiring emergency intervention like hemoperitoneum, renal vein perforation and ureteroarterial fistula have been reported. 1 , 4 Dundar et al reported the first case of renal parenchymal perforation with subcapsular hematoma due to double J stent in a patient with a solitary kidney and was managed by repositioning the stent.…”

Section: Discussionmentioning

confidence: 99%

“… 5 Two more similar cases of renal parenchymal perforation with perirenal collection (hematoma/urinoma) were reported by Nomikos et al, Aditya Pradhan et al and Gönülalan U et al which were managed by stent repositioning or removing it. 1 , 3 , 4 Presenting with a renocolic fistula is a very rare complication post double J stenting for relieving ureteral obstruction due to urinary calculi and a thorough review of literature revealed no similar reports. Our patient was managed endourologically by replacing with a new double J stent (which was removed cystoscopically after one month), patient is under regular follow-up and is doing well with no complications.…”

Section: Discussionmentioning

confidence: 99%