Indwelling ureteral stents: percutaneous management of complications.

LeRoy, Andrew J.; Williams, Harold L.; Segura, Joseph W.; Patterson, D E; Benson, Ralph C.

doi:10.1148/radiology.158.1.3510020

Cited by 74 publications

(13 citation statements)

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“…25 Some investigators have reported high success rates in managing calcified stents using endourologic techniques in a single anesthetic setting 24,26,27 ; however, it is not unusual to need multiple sessions to successfully render the patient stent and stone free, depending on which modalities are used. 15,17,28 Antegrade nephroscopy and ureteroscopy can also serve as alternative means to access the proximal collecting system to perform lithotripsy on calcified ureteral stents. 16 The percutaneous route, as with uncomplicated nephrolithiasis, is the preferred primary approach when stone size is greater than 2 cm and/or if there is associated significant encrustation on the proximal ureteral end of the stent.…”

Section: Evaluation Of Encrusted Stent and Selection Of Extraction Tementioning

confidence: 99%

“…16 The percutaneous route, as with uncomplicated nephrolithiasis, is the preferred primary approach when stone size is greater than 2 cm and/or if there is associated significant encrustation on the proximal ureteral end of the stent. 17,18,28 In the case of simultaneous large proximal and distal encrustations, the issue of which encrusted end to address first, proximal or distal, is a matter of preference and severity of stone burden. However, managing the lower coil first transurethrally, placing a ureteral catheter retrograde, and repositioning the patient to the prone position to obtain percutaneous access to manage the upper coil is an efficient and logical approach.…”

Section: Evaluation Of Encrusted Stent and Selection Of Extraction Tementioning

confidence: 99%

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Encrusted Urinary Stents: Evaluation and Endourologic Management

VanderBrink

Rastinehad

Ost

et al. 2008

Journal of Endourology

103

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Ureteral stents and nephrostomy tubes have been used extensively in urology. Attendant to their use are their associated morbidities, such as pain, infection, and encrustation. We review the literature on the subject of the encrusted stents and drainage catheters, discuss the risk factors for encrustation, and describe the endourologic evaluation and management of these encrusted and retained urinary drainage devices. A variety of factors contribute to the rate at which this process occurs, including the material of the stent or catheter, urine composition, and duration of use. The risk of stent encrustation is increased in patients with a history of urolithiasis and with progressively longer indwelling times. Novel stent designs incorporating antimicrobial eluting stents and stents with enzymes to degrade urinary oxalate have shown promise in vitro to minimize stent morbidity. Imaging plays a pivotal role in determining the appropriate surgical management of the encrusted and retained stent. In cases in which encrustation is minimal, extracorporeal shock wave lithotripsy has been used with high success rate. Calcifications along the ureteral component of the stent can be treated with retrograde ureteroscopy and laser lithotripsy while the percutaneous route is the preferred primary approach when stone size is greater than 2 cm and/or if there is associated significant encrustation on the proximal ureteral end of the stent. It is not unusual to need multiple sessions to successfully render the patient stent and stone free, depending on which modalities are used. A computerized tracking system for patients with indwelling ureteral stents has been advocated to reduce the number of "forgotten" stents. Finally, it is of paramount importance that the treating urologist communicates clearly to the patient the presence of any internal urologic stents, the temporary intent of their use, risks with prolonged indwelling times, and the need for appropriate follow-up to avoid complications of encrustation.

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Section: Evaluation Of Encrusted Stent and Selection Of Extraction Tementioning

confidence: 99%

Section: Evaluation Of Encrusted Stent and Selection Of Extraction Tementioning

confidence: 99%

Encrusted Urinary Stents: Evaluation and Endourologic Management

VanderBrink

Rastinehad

Ost

et al. 2008

Journal of Endourology

103

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“…Without prompt and appropriate management, such complications can be fatal. They can arise in several situations, including in extirpative surgery for malignant pelvic or abdominal disease, with previous vascular reconstruction procedures, and in degenerative iliac artery disease [1,2]. Vein complications involving the ureter are even less common than are arterial complications.…”

Section: Introductionmentioning

confidence: 99%

Misplacement or Migration? Extremely Rare Case of Cardiac Migration of a Ureteral J Stent

et al. 2014

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A 29-year-old woman with mild back pain when coughing and suprapubic discomfort after voiding was admitted to Pusan National University Hospital. Two weeks earlier, she had undergone a hysterectomy and right-sided ureteroneocystostomy for uterine atony and right ureteral injury with bladder rupture. Computed tomography showed that a ureteral J stent extended from the right ovarian vein to the right cardiac chamber. The stent was retrieved via both femoral veins with a snare loop and pigtail catheter. Computed tomography showed that the urinary and vascular tracts were normal 5 months after the procedure.

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“…[1] Retrograde retrieval, however, can be difficult or impossible because of proximal migration of the stent, encrustation, previous surgery on the bladder, altered anatomic features of the ureter/vesicoureteric anastomosis, inability to maintain lithotomy position, or enlargement of the prostate. [8] Shin et al . have also elaborated few other reasons for difficult retrograde stent removal including history of surgery resulting in an inaccessible retrograde route, urethral stricture, fragmentation of the proximal stent, and inability to find the ureteral orifice with a cystoscope.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous removal of impacted double J stent in a transplant kidney

Kumar

Das

Seenu

et al. 2016

Indian Journal of Radiology and Imaging

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Prophylactic double J (DJ) stent insertion has been adopted as a routine procedure in renal transplant patients for internal urinary diversion and for protecting ureteroneocystostomy anastomosis. The timely and early removal of stent has been proved to reduce the occurrence of stent-associated complications such as migration, encrustation, and infection. The most commonly used procedure of stent removal via retrograde cystoscopic approach can sometimes be technically very difficult leaving antegrade approach as another alternative to open surgery as the last resort. Here, we describe a case of antegradely removed impacted DJ stent by pushing it free into the urinary bladder followed by cystoscopic removal.

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Indwelling ureteral stents: percutaneous management of complications.

Cited by 74 publications

References 0 publications

Encrusted Urinary Stents: Evaluation and Endourologic Management

Encrusted Urinary Stents: Evaluation and Endourologic Management

Misplacement or Migration? Extremely Rare Case of Cardiac Migration of a Ureteral J Stent

Percutaneous removal of impacted double J stent in a transplant kidney

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