The FECal Double-J: A Simplified Approach in the Management of Encrusted and Retained Ureteral Stents

Treatment of forgotten ureteral stents: how much does it really cost? A cost-effectiveness study in 27 patients

“…However, in the literature frequent usage of multimodal treatment principles is remarkable [11,12,18,24]. Especially in the presence of incrusted intrarenal segment of DJS, use of PCNL or open procedures has been frequently reported [25]. We attributed widespread usage of these modalities to complicated and selective nature of these presented case reports.…”

“…The correlation between prolonged stent indwelling time, and degree of incrustation is clearly revealed. As retention time of FUS increases, incrusted ureteral segments lengthen, and thicken [8,25] which require additional procedures for the extraction of the stent. Therefore, treatment cost of removal of FUS is expected to rise directly proportional to stent retention time.…”

A Simple Two-stage “Bailout” Technique for the Removal of an Unyielding Ureteric Stent

“…[2][3][4] Encrustation of the lower (vesical) end of the stent can be managed with endoscopic litholapaxy or lasertripsy. Encrustation of the upper or middle portion of the stent is suitably dealt with by rigid or flexible ureteroscopy and lasertripsy, with a general anesthetic required for such interventions.…”

Prone split-leg position to manage encrusted ureteral stents in a single-stage procedure in women: Step-by-step surgical technique

“…The term ''forgotten, encrusted, calcified (FECal)'' double-J ureteral stent was created to describe stents which cannot be removed cystoscopically without the aid of other auxiliary measures due to encrustation and/or stone formation. 11 The two most severe types of stent encrustation are Grade IV (circular encrustations completely encasing both of the pigtail portions of the stent) and Grade V (diffuse and bulky encrustations completely encasing both of the pigtail and ureteral portions of stent). 11 The ideal method for stent encrustation image evaluation is the non-contrast computed tomography (NCCT), as the standard kidney-ureter-bladder x-ray may miss minor encrustations which can also intricate their removal.…”

“…The term ''forgotten, encrusted, calcified (FECal)'' double-J ureteral stent was created to describe stents which cannot be removed cystoscopically without the aid of other auxiliary measures due to encrustation and/or stone formation. 11 The two most severe types of stent encrustation are Grade IV (circular encrustations completely encasing both of the pigtail portions of the stent) and Grade V (diffuse and bulky encrustations completely encasing both of the pigtail and ureteral portions of stent).11 The ideal method for stent encrustation image evaluation is the non-contrast computed tomography (NCCT), as the standard kidney-ureter-bladder x-ray may miss minor encrustations which can also intricate their removal.Treatment modalities for encrusted stents include extracorporeal shock wave lithotripsy (SWL), cystolithotopaxy, retrograde rigid or flexible ureteroscopy with intracorporeal lithotripsy (URS), percutaneous nephrolithotomy (PCNL), open surgery, and a combination of those methods. [12][13][14][15][16][17][18][19][20] Although there are no formal guidelines in the management of encrusted double-J stents, 15 several authors have reported their series and proposed algorithms: some with multiple sequential surgical techniques; 15,[19][20][21][22][23] others with a one-step approach.…”