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

Abstract

there are different complications of using ureteral stents in urology field, one of the challenging complications is stent fragmentation which is frequent in patients with missed and forgotten stents accompanying encrustation, presented case was 70- year-old female, left single kidney with stent fragmentation After TUL and stent insertion one year ago, because of retained fragments in kidney, ureter, and bladder, combined antegrade and retrograde approach was used for stent fragments extraction, for preventing stent related complications we should signify the importance of timely extraction of ureteral stents during inpatient and outpatient visits and using remembrance methods.

Endoscopic combined intrarenal surgery in the prone-split leg position for successful single session removal of an encrusted ureteral stent: a case report

“…Thereby reduceing the risk of postoperative infection. Different from other reports [10][11][12], this case is treated in one position combined with intravesical lithotripsy, retrograde ureteroscopy and percutaneous nephrolithotripsy. The whole process of puncture and removal of stent tube is monitored.…”

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

“…The exact reason for this early SSF is difficult to ascertain from the current report but it is unlikely to be due to stent encrustation and calcification like the previous reports. [4][5][6]9 One possible cause is the presence of a very hostile urine environment in these two patients. The first patient was a construction laborer who works outside in a very hot environment and had long periods of dehydration.…”

“…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 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 10‐12 . The vast majority of the previously reported cases were associated with calcifications and encrustation of stents which had been neglected or forgotten for longtime 4‐6,9 . Herein, we report, for the first time, on two cases in which the SSF has occurred as early as 3 and 5 weeks post‐insertion and reflect on the possible causes and ways to prevent this early complication.…”

“…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.…”