Forgotten Ureteral Stents in a Tertiary Hospital in Accra and a Review of Endourological Management of Upper Urinary Tract Pathologies in the West Africa Sub-Region

Abstract

Background: Forgotten ureteral stent is defined as prolong indwelling ureteral stent whose function is no longer desired. Ureteral stents are used in the management of upper urinary tract pathologies. Prolonged indwelling ureteral stents may be complicated by urosepsis or renal failure, encrustation, stone formation, spontaneous fracture which may either be retained or voided in the urine (stenturia). Hitherto, these complications were managed by open procedures alone in our center. We report our recent experience in endourology with the management of three cases of forgotten ureteral stents with durations of ten years and two years (two cases) and review endourological practice in West Africa. Conclusion: Although encrusted stents can be managed successfully by minimally invasive approaches in the majority of cases, the best treatment is prevention. Urology units should have preferably an electronic stent register such that when the time for removal is due, the patient's name and details are flagged red. If electronic register is not available, then a hard paper/book register should be made to prevent situations of forgotten stents. Also, efforts must be made to improve endourological services in the West Africa sub-region to allow patients to have the benefit of endourology in the management of upper urinary tract pathologies including that of stones originating from an encrusted or fractured forgotten ureteral stent.

Ureteric Catheterization Using Infant Feeding Tubes Following Ureteroneocystostomy in a Low Resource Setting

“…Our patients had ureteric stents for 7-10 days though duration of six days to six weeks have been reported [12,14,18,19].…”

“…Consequences and complications of ureteral stent placement are irritative voiding symptoms, incontinence, suprapubic or flank pain, vesicorenal reflux, hematuria, pyuria, urinary tract infection, malposition, migration, inadequate relief of obstruction, encrustation, ureteral erosion or fistulization, fracture and forgotten stent [1,3,6,[10][11][12].…”