Ureteral stent complications – experience on 50,000 procedures

Abstract

Double J stent is an essential tool in urology, being a basic part of many urological procedures. However, some issues related to their use still occur. Our study aimed to evaluate an important number of procedures, the complications of ureteral stents, and their prevention and treatment retrospectively. We evaluate 50,000 procedures performed between 1996 and 2021 on 36,688 patients. According to the stenting duration, the cases were divided into short-term (less than 6 weeks – 34,213 procedures), respectively long-term stenting (more than 6 weeks – 15,757 procedures). The indications of stenting for both groups were noted. The total number of complications was 41,369. We encountered 153 cases (0.3%) of JJ stent malposition, of which 3 cases were into the retroperitoneum, one case with parenchymal perforation and hematoma. Considering the double J migrations, we found proximal migration in 427 cases (0.9%) and distal double J migrations in 352 (0.7%) cases. The obstruction of the ureteral stent, causing inefficient drainage, was encountered in 925 cases, while irritative bladder symptoms occurred in 16,326 cases (32.7%). Hematuria was observed in 5,213 cases, in 7 cases blood transfusion being nec-essary. Urinary tract infection was diagnosed in 7,436 cases (14.8%). Stent encrustation and calcification occurred in 832 cases, while stent fragmentation was noted in 52 cases. Double J stent complications should be promptly evaluated and treated. Encrustation and stone formation in forgotten stents often lead to serious complications and should be managed with stent removal and combined endourological techniques.

Safety and Efficacy of Flexible Ureterorenoscopy Surgery: Results of Our Large Patient Series

“…Postoperative stenting decreases hydronephrosis, increases the rate of spontaneous stone fragmentation passing, and reduces ureter stricture [4]. However, it should be kept in mind that ureter stents are associated with some morbidities such as irritative symptoms, bacteriuria, and sexual dysfunction [13]. In our study, preoperative stenting was not routinely performed and the rate of preoperative stenting was 25%.…”

Analysis of Characteristics, Pathogens and Drug Resistance of Urinary Tract Infection Associated with Long-Term Indwelling Double-J Stent

“…It is widely used in clinic because it can relieve urinary obstruction, drain urine and protect renal function. 17,18 In recent years, the rapid development of endourological technology has greatly increased the indication and application range of double-J stent implantation. [17][18][19][20] Clinically, the duration of double-J stent indwelling is generally 2 to 6 weeks, but due to the complexity of patients' conditions, the duration of double-J stent indwelling in some patients can be as long as half a year to one year.…”

“…17,18 In recent years, the rapid development of endourological technology has greatly increased the indication and application range of double-J stent implantation. [17][18][19][20] Clinically, the duration of double-J stent indwelling is generally 2 to 6 weeks, but due to the complexity of patients' conditions, the duration of double-J stent indwelling in some patients can be as long as half a year to one year. However, prolonged double-J stent indwelling will cause patients pain, bladder irritation, hematuria, fever, etc.…”

“…Among them, double-J stent-related infection is a common complication of double-J stent indwelling, which can lead to retrograde urogenic sepsis and endanger the life safety of patients in severe cases. [17][18][19][20] The colonization of bacteria on ureteral stent is an important problem. Bacteria can interact and adhere to the surface of bare double-J tube.…”

Ureteric stent associated spondylodiscitis

“…Decision making is influenced by patient, surgical and resource factors2 and options include: (1) extracorporeal shock wave lithotripsy; (2) ureteric stent insertion and delayed ureteroscopy (URS); (3) primary URS and laser stone fragmentation3 and (4) percutaneous nephrolithotomy for very large proximal ureteric stones. The use of the ureteral stent remains controversial and is accompanied by possible side-effects, including urinary tract infection (UTI), haematuria and lumbar pain 4…”