Management of encrusted ureteral stents impacted in upper tract

Bultitude, Matthew; Tiptaft, R. C.; Glass, Jonathan; Dasgupta, Prokar

doi:10.1016/s0090-4295(03)00506-5

Cited by 129 publications

(98 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Common are prolonged duration of stenting, urinary sepsis, previous history or simultaneous occurrence of stone disease, chemotherapy, chronic renal failure, and metabolic or congenital anomalies. 2 In our case series with forgotten DJS, the most prominent factor was the previous existence of urolithiasis. Conflicting reports have been published about the effect of stent composition on the severity of encrustation.…”

Section: Discussionmentioning

confidence: 62%

See 1 more Smart Citation

Management of Forgotten Ureteral Double J Stents: Causes and Management

Anwar¹,

Farooq²,

Ayub³

et al. 2017

APMC

View full text Add to dashboard Cite

Introduction: Double J stent (DJS) is a basic and valuable tool in urological practice. A forgotten DJS is not uncommon and is associated with significant morbidity and mortality. The presenting complaints may range from UTI to renal failure. Therefore, this study has been carried out to assess the clinical spectrum of this entity in our setting. Objective: To describe the clinical presentation, complications and management of forgotten DJS. Methods: This retrospective descriptive study was done at the Department of Urology, Services Institute of Medical Sciences, Lahore (SIMS) from August 2015 to December 2016. Sixteen patients with forgotten DJS were included. Each patient was studied for age, gender, presenting complains, indication of DJS, duration of stent insertion and management performed. The data was recorded on a proforma and analyzed using SPSS version 20. Results: 16 patients 68.8% (n=11) male and 31.2% (n=5) female patients were included in study. The average age was 46.38 ± 13.58 (23-65 years). The mean indwelling time of DJS was 16.31 ± 32 months. 50% of patient's had obstructive uropathy due to stones. Most patients had UTI (37.5%) at presentation while mild encrustation was the major complication encountered (43.8%). Majority of patients were not compliant to the advice for DJS removal. Conclusion: Forgotten DJS leads to multiple complications, if not intervened timely. They can be successfully removed employing least invasive endourologic techniques. Proper counseling of patient/relatives is needed to get it removed in the due time period.

show abstract

Section: Discussionmentioning

confidence: 62%

“…2 In the last decade, new materials and stents have been designed in the presence of important technological innovations and developments to improve patient tolerance and to overcome stentrelated problems. 3 With the widespread use of indwelling ureteral stents by urologists, issues related to their use have also increased.…”

Section: Introductionmentioning

confidence: 99%

Management of Forgotten Ureteral Double J Stents: Causes and Management

Anwar¹,

Farooq²,

Ayub³

et al. 2017

APMC

View full text Add to dashboard Cite

show abstract

“…In the present case, the stent was in situ for 6 years, and the patient developed stone formation, encrustation and UTI. Numerous previous studies have reported various multimodal endourologic approaches to remove encrusted and retained stents, including extracorporal shockware lithotripsy, ureteroscopy with or without intracorporal retrieval, and percutaneous nephrolithotmy (20)(21)(22). For long-term D-J stents with severe encrustation, ureteroscopy in combination with holmium laser lithotripsy could represent an alternative, minimally invasive treatment option (4).…”

Section: Discussionmentioning

confidence: 99%

Use of cystourethroscopy to remove an indwelling double-J ureteral stent 6 years following simultaneous radical sigmoid colon cancer and partial bladder resection: A case report

Zhang

Wang

2016

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

Abstract. Ureteral stents are widely used to ensure good urinary drainage and to relieve obstruction, pain and infection during urologic procedures. However, long-term indwelling ureteral stents can cause various complications, such as encrustation, hematuria and infection. Here, the case of an 88-year-old man who had undergone simultaneous radical resection of sigmoid colon cancer and partial resection of the bladder 6 years prior is presented. The patient complained of urinary frequency and urgency, dysuria and intermittent fever. A kidney ureter bladder X-ray examination revealed the presence of an entire coiled double-J stent with calculi from the kidney to the bladder. A computed tomography scan revealed mild hydronephrosis of the left kidney and one J end of the stent in the bladder. The stent was removed successfully by cystourethroscopy and holmium laser lithotripsy. This report describes the clinical experience of the removal of a long-term stent by endoscopic manipulation.

show abstract

“…17 A review of the literature suggests that the mean number of endourologic procedures per patient with a significant stone burden related to the forgotten stent ranges from 1.9 to 4.2. [15][16][17]22,24 In contrast, Bukkapatnam and colleagues reported a case series of 12 forgotten stents in 10 patients successfully treated with a one-stage percutaneous approach with minimal morbidity. 18 Nevertheless, stone burden of those two series were not similar.…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14][15][16][17][18][19][20] Although there are no formal guidelines in the management of encrusted double-J stents, 15 several authors have reported their series and proposed algorithms: some with multiple sequential surgical techniques; 15,[19][20][21][22][23] others with a one-step approach. 18,24 Even in this single approach technique, after cystolithopaxy or URS in lithotomy position, the patient must be turned prone for PCNL.…”

Section: Introductionmentioning

confidence: 99%

Prone split-leg position to manage encrusted ureteral stents in a single-stage procedure in women: Step-by-step surgical technique

Marchini

Torricelli

Mazzucchi

et al. 2015

CUAJ

View full text Add to dashboard Cite

The management of encrusted ureteral stents is costly, time consuming and may be risky for the patient and challenging for the urologist. Treatment modalities for encrusted stents include extracorporeal shock wave lithotripsy, cystolithopaxy, rigid or flexible ureteroscopy with intracorporeal lithotripsy, percutaneous nephrolithotomy, open surgery, and a combination of those methods. In this study we describe the management of severe forgotten encrusted ureteral stents in 3 female patients using a prone splitleg position. This position allows us to effectively treat any site and degree of stent encrustation in a single-session approach with the patient in the same position during the whole procedure. All patients were rendered stent and stone free. No complications occurred. IntroductionIndwelling ureteral stents were introduced in 1967 and were instrumental in the advance of endourology.1 Ureteral stents are mainly used to manage ureteral obstruction due to intrinsic or extrinsic causes (e.g., urolithiasis, strictures, and malignancy) or after any ureteral surgery.1-4 Modern ureteral stents are usually designed in a double-pigtail configuration and are composed of polyurethane and/or polyethylene.5 New biomaterials and ureteral stent coatings, such as heparin and diamond-like carbon compounds, may reduce infection and encrustation rates.6-8 Nevertheless, underlying stone-forming conditions, pregnancy, and total indwelling-stent time affect the level of encrustation. Stent encrustation rates may increase from 9.2% at <6 weeks to 76.3% at >12 weeks. 9The management of encrusted ureteral stents is costly, time consuming and may be risky for the patient and challenging for the urologist. 10 The degree and site of encrustation are important considerations when dealing with forgotten stents. The term ''forgotten, encrusted, calcified (FECal)'' double-J ureteral stent was created to describe stents which cannot be removed cystoscopically without the aid of other auxiliary measures due to encrustation and/or stone formation. 11 The two most severe types of stent encrustation are Grade IV (circular encrustations completely encasing both of the pigtail portions of the stent) and Grade V (diffuse and bulky encrustations completely encasing both of the pigtail and ureteral portions of stent).11 The ideal method for stent encrustation image evaluation is the non-contrast computed tomography (NCCT), as the standard kidney-ureter-bladder x-ray may miss minor encrustations which can also intricate their removal.Treatment modalities for encrusted stents include extracorporeal shock wave lithotripsy (SWL), cystolithotopaxy, retrograde rigid or flexible ureteroscopy with intracorporeal lithotripsy (URS), percutaneous nephrolithotomy (PCNL), open surgery, and a combination of those methods. [12][13][14][15][16][17][18][19][20] Although there are no formal guidelines in the management of encrusted double-J stents, 15 several authors have reported their series and proposed algorithms: some with multiple sequential surgical t...

show abstract

Management of encrusted ureteral stents impacted in upper tract

Cited by 129 publications

References 15 publications

Management of Forgotten Ureteral Double J Stents: Causes and Management

Management of Forgotten Ureteral Double J Stents: Causes and Management

Use of cystourethroscopy to remove an indwelling double-J ureteral stent 6 years following simultaneous radical sigmoid colon cancer and partial bladder resection: A case report

Prone split-leg position to manage encrusted ureteral stents in a single-stage procedure in women: Step-by-step surgical technique

Contact Info

Product

Resources

About