Endourological management of encrusted ureteral stents: An up-to-date guide and treatment algorithm on behalf of the European Association of Urology Young Academic Urology Urolithiasis Group

Juliebø‐Jones, Patrick; Pietropaolo, Amelia; Æsøy, Mathias Sørstrand; Ulvik, Øyvind; Beisland, Christian; Bres-Niewada, Ewa; Somani, Bhaskar

doi:10.5173/ceju.2021.0264

Cited by 7 publications

(4 citation statements)

References 27 publications

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“…In case of stone burden in renal pelvis, it can be treated by RIRS or PCNL. Endoscopic combined intrarenal surgery (ECIRS) may be preferred in cases of high encrustation and stone burden in the ureter and renal part (6,10). Today, although the rates of endourological approaches have increased, open surgery is still a good option in difficult cases (1).…”

Section: Discussionmentioning

confidence: 99%

“…Treatment of forgotten dj stents can sometimes be difficult and complicated for urologist depending on the degree of encrustation and the complications (1,6). Percutaneous nephrolithotomy (PCNL), ureteroscopy (URS), retrograde intrarenal surgery (RIRS), transuretral cystolithotripsy and the combine surgeries can be used for removal of encrusted stents.…”

Section: Introductionmentioning

confidence: 99%

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Approach to Forgotten Ureteral Stents: A Single Tertiary Center Experience of 49 Cases

Canakcı,

Dinçer,

Doğrusever

et al. 2024

Endourol Bull

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Objective: Double J (DJ) stents are widely used in urology practice. Forgotten ureteral stents can cause serious complications. We present our experience about forgotten ureteral stents with 49 cases. Material and Methods: The data of patients who were operated due to forgotten encrusted ureteral stents were examined retrospectively. Age, gender, side, presenting complaint, indwelling time, stent indication, surgery performed, complications, additional interventions and stone-free status were evaluated. For descriptive statistics, the mean, standard deviation, minimum and maximum frequencies and percentages were used. Results: Nineteen (38.8%) patients were female and 30 (61.2%) patients were male. The mean age of the patients was 47,06±14,11 (18-79). The mean indwelling time was 16.2±21,1 (3-120). Stents were placed in 30 patients due to stone surgery, 9 patients due to prophylactic before oncologic surgery, 8 patients due to hydronephrosis and two patients due to ureteral injury. For the treatment of the forgotten stent, ureteroscopy (including flexible ureterorenoscopy) was performed in 26 patients, endoscopic combined treatment in 11 patients, cystolithotripsy in 9 patients, open surgery in two patients and percutaneous nephrolithotomy in one patient. Conclusion: Removal of forgotten impacted ureteral stents can cause serious complications. The patients who were placed stents should be informed about the complications associated with forgotten encrusted stents.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Approach to Forgotten Ureteral Stents: A Single Tertiary Center Experience of 49 Cases

Canakcı,

Dinçer,

Doğrusever

et al. 2024

Endourol Bull

View full text Add to dashboard Cite

show abstract

“…Multimodal surgery is generally required. A systematic review on behalf of the EAU YAU Urolithiasis Group revealed that 27% of the encrusted stents require a combined surgery, followed by 24% of URS alone or 19% of SWL alone as a single surgery ( 29 , 30 ). Because of the short indwelling time, the encrustations included in our study are principally low or median degrees by three evaluation tools, which are not easily identifiable.…”

Section: Discussionmentioning

confidence: 99%

Identifying ureteral stent encrustation using machine learning based on CT radiomics features: a bicentric study

et al. 2023

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ObstructiveTo develop and validate radiomics and machine learning models for identifying encrusted stents and compare their recognition performance with multiple metrics.MethodsA total of 354 patients with ureteral stent placement were enrolled from two medical institutions and divided into the training cohort (n = 189), internal validation cohort (n = 81) and external validation cohort (n = 84). Based on features selected by Wilcoxon test, Spearman Correlation Analysis and least absolute shrinkage and selection operator (LASSO) regression algorithm, six machine learning models based on radiomics features were established with six classifiers (LR, DT, SVM, RF, XGBoost, KNN). After comparison with those models, the most robust model was selected. Considering its feature importance as radscore, the combined model and a nomogram were constructed by incorporating indwelling time. Accuracy, sensitivity, specificity, area under the curve (AUC), decision curve analysis (DCA) and calibration curve were used to evaluate the recognition performance of models.Results1,409 radiomics features were extracted from 641 volumes of interest (VOIs) and 20 significant radiomics features were selected. Considering the superior performance (AUC 0.810, 95%CI, 0.722–0.888) in the external validation cohort, feature importance of XGBoost was used as a radscore, constructing a combined model and a nomogram with indwelling time. The accuracy, sensitivity, specificity and AUC of the combined model were 98, 100, 97.3% and 0.999 for the training cohort, 83.3, 80, 84.5% and 0.867 for the internal cohort and 78.2, 76.3, 78.8% and 0.820 for the external cohort, respectively. DCA indicates the favorable clinical utility of models.ConclusionMachine learning model based on radiomics features enables to identify ureteral stent encrustation with high accuracy.

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“…Traditionally, PCN or ureteral stent insertion has also been adopted to manage all patients with symptomatic KSD diagnosed during pregnancy where conservative measures have failed. However, it is problematic as the greater rates of encrustation in pregnancy often require stent exchange every 4 to 6 weeks [37]. PCNs and indwelling ureteral stents can also have a deleterious effect on quality of life.…”

Section: Temporising Measuresmentioning

confidence: 99%

Management of Kidney Stone Disease in Pregnancy: A Practical and Evidence-Based Approach

et al. 2022

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Purpose of Review Suspected kidney stone disease during pregnancy is a difficult condition for health professionals to manage. This is partly due to the more limited range of diagnostic and therapeutic strategies, which can be safely applied. A comprehensive review of literature was performed to identify evidence to develop a practical guide to aid clinicians. Recent Findings Ultrasound remains the recommended first line option for imaging. Complicated cases, such as suspected infected obstructed system, require urgent decompression such as in the form of percutaneous nephrostomy. This article highlights the pharmacotherapeutic agents, which are considered safe for use in pregnancy. Where surgical intervention is indicated, evidence supports ureteroscopy to be a safe option as long as infection has been treated. Ureteroscopy can offer definitive clearance of the stone(s) and can be less burdensome regarding bothersome symptoms compared to indwelling ureteral stent or nephrostomy, which also require regular exchange due to the high propensity for encrustation in pregnancy. Summary A multidisciplinary approach is fundamental to safely manage suspected kidney stone disease in pregnancy. Adoption of a locally agreed pathway as suggested in this article supports improved patient care.

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Endourological management of encrusted ureteral stents: An up-to-date guide and treatment algorithm on behalf of the European Association of Urology Young Academic Urology Urolithiasis Group

Cited by 7 publications

References 27 publications

Approach to Forgotten Ureteral Stents: A Single Tertiary Center Experience of 49 Cases

Approach to Forgotten Ureteral Stents: A Single Tertiary Center Experience of 49 Cases

Identifying ureteral stent encrustation using machine learning based on CT radiomics features: a bicentric study

Management of Kidney Stone Disease in Pregnancy: A Practical and Evidence-Based Approach

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