From Routine to Exceptional: Exploration of a Unique Case of Bilateral Renal Parenchymal Perforation and Unilateral Hematoma Formation after Double J Ureteral Stent Insertion

Abstract

Double J stent is a routine procedure in urology. Today, it is used for a wide range of indications. Their use is not without consequences. Complications may be frequent or rare, minor or serious. Perforation of the renal parenchyma, with or without the formation of a hematoma, is a serious complication that is considered very rare. In this report, we report the case of a 70-year-old patient who underwent bilateral double-J ureteral stent for obstructive renal failure due to prostate cancer. He presented to our center 20 days later with low back pain, diuresis failure and renal insufficiency on the laboratory work-up. Further work-up, mainly imaging (ultrasound and CT scan), revealed a lateral perforation of the renal parenchyma, complicated on the left by the formation of a hematoma. Management consisted in changing the double J probes. The outcome was favorable, with improvement in clinical signs and biological parameters. This routine procedure can be unexpectedly complicated by exceptional situations. On the basis of this case and existing literature, the various aspects will be analyzed and discussed.