Complications and Management of Retained Double-J Stents in Children During the Coronavirus Disease-2019 Pandemic

Abstract

Background: Double-J (DJ) stents were commonly used for internal drainage after major reconstructive procedures or in cases of obstruction and ureteral injuries. They should be removed or changed within the stipulated time; otherwise, they can lead to various complications such as stent occlusion, migration, breakage, encrustation, stone formation at either end of the stent, and entanglement of the two stents if bilateral stenting was done. The present study focuses on the complications and the management due to delay in the removal of the DJ stents due to the coronavirus disease-2019 pandemic. Materials and Methods: This is a cross-sectional study over a period of 9 months. Children <12 years were included in the study. The patients' demographic data, indication for DJ stenting, time gap between DJ stenting and removal, complication with delay in DJ stent removal, and its management were recorded. Indwelling duration for >4 months was considered a delay in removal. All patients were followed up for 3 months. Results: A total of 10 patients were included in the study. Encrustation, proximal migration, distal migration, knotting of the stent, and entanglement of the bilateral stents in the bladder were observed. These complications were managed by various endourological procedures such as ureteroscopy, percutaneous nephroscopic, and cystoscopic removal. During follow-up, all patients were symptom-free. Conclusion: Prolonged indwelling stents can cause various complications. Endourological procedures are an essential armamentarium for a pediatric surgeon to manage these complications. Proper patient counseling regarding indwelling stents and maintaining stent registry and sending automatic messages and e-mails to patients may prevent these complications.

Neglected case of recurrent abdominal pain due to a chronically retained and broken double J (DJ) stent following percutaneous nephrolithotomy (PCNL): A case report

“…Retained DJ stents can occur due to several reasons, including patient noncompliance, lack of proper follow-up, failure to remove the stent, and technical difficulties during insertion or removal. The most common reason for retained stents are patient noncompliance, accounting for approximately 40% of cases [3] . Another study reported that around 25% of patients did not receive adequate information about the importance of stent removal, resulting in delayed or failed removal.…”