Forgotten Double J Stent with Maximum Stone Burden

Abstract

Double J stent or DJ stent, is a self-retaining ureteral stent mainly used to provide effective drainage of kidney into urinary baldder. However, because of widespread use, lack of patient education or due to lack of adherence to regular follow up,patients may end up with a forgotten DJ stent which can stay undiagnosed in the pelvi-ureteral system for years and cause a lot of complications before coming to attention. We present a unique case of repetitively neglected (forgotten) DJ stent in a 28-year-old male, who had the stent placed 11 years back as a part of Percutaneous Nephrolithotomy (PCNL) and now presentedwith encrusted DJ stent with large bladder calculus and calculus deposits along entire length of the stent. To our knowledge, this study reports the forgotten stent with the maximum stone burden available in literature.

Neglected ureteral stent in a patient with chronic kidney disease and solitary functioning kidney: case report and review of literature

“…Lack of urinary acidification has been identified as a significant risk factor for complex stent removal procedures, with urine acidification helping to prevent complications 24 . The material of the stent also plays a role, with silicone DJS having lower incidence of encrustation compared to polyurethane stents 7 , 12 . We were not able to contact our patient’s previous surgeon to determine the material of his DJS.…”

“…The treatment and intervention of forgotten DJS depend on the patient’s preoperative status and the severity of associated complications, including encrustation, stone formation, stent migration, and fragmentation 12 . In most cases, endourological procedures can be undertaken, with few requiring open surgery.…”