Can the Complicated Forgotten Indwelling Ureteric Stents be Lethal?

Singh, Vishwajeet; Srinivastava, A; Kapoor, Rakesh; Kumar, Anant

doi:10.1007/s11255-004-4704-6

Cited by 124 publications

(78 citation statements)

References 18 publications

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“…These forgotten stents can produce considerable morbidity and mortality, due to extensive encrustation with significant stone burden, knot formation, upward migration and fragmentation (7,15). Encrustation of forgotten stents associated with large stone burden is a serious problem, due to complications like recurrent urinary tract infection, hematuria, obstruction and renal failure (16). The deposition of encrusted material on retained ureteral stents can occur in both infected and sterile urine.…”

Section: Commentsmentioning

confidence: 99%

Endourological Management of Forgotten Encrusted Ureteral Stents

2010

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Purpose: To present our experience and discuss the various endourological approaches for treating forgotten encrusted ureteral stents associated with stone formation. Materials and Methods: From July 2006 to December 2008, 14 patients (11 men and 3 women) with encrusted ureteral stents were analyzed. The average indwelling time of the stent was 4.9 years (range 1 to 12). Plain-film radiography was used to evaluate encrustation, stone burden, and fragmentation of the stents. Intravenous urogram and a Tc99m diethylene triamine penta acetic-acid renogram was used to assess renal function. Results: In seven patients, the entire stent was encrusted, in three patients the encrustation was confined to the ureteral and lower coil part of the stent, two patients had encrustation of the lower coil, and minimal encrustation was observed in two patients. Percutaneous nephrolithotomy was performed in 5 cases and retrograde ureteroscopy with intra-corporeal lithotripsy in 9 patients. Cystolithotripsy was used to manage the distal coil of the encrusted stent in eight patients. Simple cystoscopic removal of the stents with minimal encrustation was carried-out in two cases. Looposcopy and removal of the stent was performed in one patient with an ileal conduit and retained stent. Only one patient required open surgical removal of the stent. Thirteen out of 14 patients were rendered stone and stent free in one session. All except two stents were removed intact and stone analysis of encrustation and calcification revealed calcium oxalate and calcium phosphate in the majority of the cases. Conclusion: Endourological management of forgotten encrusted stents is highly successful and often avoids the need for open surgical techniques.

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Section: Commentsmentioning

confidence: 99%

Endourological Management of Forgotten Encrusted Ureteral Stents

2010

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“…Stent encrustation is common in the use of long-term ureteral stents. Ureteral stents that are left in place for >6 months are commonly encrusted (17)(18)(19). In the present case, the stent was in situ for 6 years, and the patient developed stone formation, encrustation and UTI.…”

Section: Discussionmentioning

confidence: 63%

Use of cystourethroscopy to remove an indwelling double-J ureteral stent 6 years following simultaneous radical sigmoid colon cancer and partial bladder resection: A case report

Zhang

Wang

2016

Experimental and Therapeutic Medicine

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Abstract. Ureteral stents are widely used to ensure good urinary drainage and to relieve obstruction, pain and infection during urologic procedures. However, long-term indwelling ureteral stents can cause various complications, such as encrustation, hematuria and infection. Here, the case of an 88-year-old man who had undergone simultaneous radical resection of sigmoid colon cancer and partial resection of the bladder 6 years prior is presented. The patient complained of urinary frequency and urgency, dysuria and intermittent fever. A kidney ureter bladder X-ray examination revealed the presence of an entire coiled double-J stent with calculi from the kidney to the bladder. A computed tomography scan revealed mild hydronephrosis of the left kidney and one J end of the stent in the bladder. The stent was removed successfully by cystourethroscopy and holmium laser lithotripsy. This report describes the clinical experience of the removal of a long-term stent by endoscopic manipulation.

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“…Encrustation of forgotten stents with large stone burden is a serious problem due to complications like recurrent urinary tract infection, haematuria, obstruction and renal failure 17 . The deposition of encrusted material on retained ureteral stents can occur both in sterile and infected urine 18 .…”

Section: Discussionmentioning

confidence: 99%

Multimodal management of forgotten encrusted ureteral stents

Dongol¹,

Ghimire

2017

J. Kathmandu Med. Coll.

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Background: Forgotten ureteral stents are seen in urologic practice because of ignorance of patients or failure of physician to counsel the patients. They can cause signifi cant morbidity and pose a management and legal dilemma. Objectives: To evaluate the effi cacy and feasibility of different endourological approaches like percutaneous nephrolithotomy, ureteroscopic lithotripsy, cystolithotripsy and extracorporeal lithotripsy in the treatment of forgotten encrusted ureteral stents. Methods: Total 10 patients with forgotten encrusted double J stents from January 2013 to Nov 2015 were included. Mean age of the patients was 38.4 years (1.5 -5 years). All patients were evaluated for stent encrustation and associated stone burden by X-ray KUB and Intravenous Urography. Combined endourological procedures like percutaneous nephrolithotomy, ureteroscopic lithotripsy, cystolithotripsy and extracorporeal lithotripsy and even open surgery was done to remove these stents. The patients characteristics, indications for stenting, indwelling time, site of encrustation, hospital stay etc were all noted. Results: Total 10 patients presented with forgotten Double J stents. Out of three patients with large encrustations both in renal pelvis and urinary bladder, one patient underwent percutaneous nephrolithotomy and cystolithotripsy. Rest two patients underwent extracorporeal lithotripsy for two sessions for renal pelvic encrustation and cystolithotripsy for urinary bladder encrustation. Four patients underwent ureteroscopic and cystolithotripsy. Two patients in whom all fractured coils were in urinary bladder, underwent cystolithotripsy. All the stents were removed under C-arm fl uoroscopic guidance. In one patient, open ureterotomy was done to remove the knotted stent. Conclusion: The use of Double J stent should be limited. The combination of various endourological techniques and extracorporeal lithotripsy can achieve effective stent and stone treatment with minimal morbidity and hospital stay.

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Can the Complicated Forgotten Indwelling Ureteric Stents be Lethal?

Abstract: The management of complicated forgotten ureteral stents need judicious use of endourological techniques and lithotripsy. The stent related complication can be directly lethal for the patient or indirectly can cause death because of complications related to operative intervention.

Cited by 124 publications

References 18 publications

Endourological Management of Forgotten Encrusted Ureteral Stents

Endourological Management of Forgotten Encrusted Ureteral Stents

Use of cystourethroscopy to remove an indwelling double-J ureteral stent 6 years following simultaneous radical sigmoid colon cancer and partial bladder resection: A case report

Multimodal management of forgotten encrusted ureteral stents

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