A New Method for Fragmented Ureteral Stent Extraction: Flexible Renoscopy

Abstract

Usage of ureteral DJ stent is very common in urology practise. There are some complications according to the increased usage of ureteral DJ stent in the literature. Stent fragmentation is a rare complication of ureteral DJ stent. In this study we present a 53-year-old male patient who had previous stone surgery and a ureteral DJ stent applied to our polyclinic with complaint of 3-months-long right side pain. In the radiologic examination we observed that DJ stent was fragmented from the upper end on the right kidney. We extracted the fragmentated part of ureteral DJ stent with flexible ureterorenoscopy.

Fragmented ureteral stent extraction by antegrade and retrograde access:using ureteroscope and nephroscope

“…Stent fracture usually occur along stent side holes, so stents with multiple side holes are susceptible for fracture 4 management of fractured stents depends on where the fragments retained, can be managed by retrograde approach using ureteroscope or antegrade approach using nephroscope or combined retrograde and antegrade approach the same management which is used in our case 5 …”

Spontaneous fragmentation of JJ stent can occur as early as 3 weeks post‐insertion: Case report

“…In this study, we report for the first time on SSF, which occurred as early as 3 weeks following stent insertion. SSF is a very rare complication 4‐6,9 . Regardless of the exact cause of stent fragmentation, both in vivo and in vitro reports have indicated that stents are more likely to fragment across the side drainage holes 2,13 …”

“…Aging of the stent has also been recognized as an important cause for stent fragmentation 10,14 . In this regard, reviewing the literature indicated that SSF had occurred in stents which have been neglected or forgotten for long periods ranging between one year to as long as 15 years which led to stent encrustations and crystal formation 4‐6,9 . There was only one report of SSF which occurred after two months of insertion 8 .…”

“…The use of double J (JJ) ureteric stent in its current form is associated with several short‐ and long‐term complications 1 . Spontaneous stent fragmentation (SSF) is a very rare but previously described complications 2‐10 . This potentially serious complication increases patients’ morbidity and requires further procedures to remove the retained fragments.…”

“…1 Spontaneous stent fragmentation (SSF) is a very rare but previously described complications. [2][3][4][5][6][7][8][9][10] This potentially serious complication increases patients' morbidity and requires further procedures to remove the retained fragments. The exact reason for SSF is unclear but has been attributed to the stent material, hostile and harsh urine environment, and the duration of leaving the stent inside the body.…”