Management of Forgotten Ureteral Double J Stents: Causes and Management

Abstract

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.

Management of ‘forgotten’ encrusted JJ stents using extracorporeal shockwave lithotripsy: A single-centre experience

“…Only three of our present patients (2.3%) required open surgery, as the stent could not be removed after four sessions of ESWL due to the longevity of stent indwelling (~5 years) and its location (the whole length of the stent). Anwar et al [15] showed that 87.5% of their study cases were managed endoscopically with a 43.8% success rate with a single cystoscopic procedure, whilst combined ESWL with endoscopic procedures was required in rest of the cases (43.6%). The open procedure was required in two cases following failed attempted URL.…”

Neglected Double-J Ureteral Stents in Upper Egypt Patients

“…Patients should be appropriately informed and made aware of the significance of stent presence. Economic issues are also a key source of concern in emerging countries such as ours (19) . Nevertheless, Jhanwar et al (20) observed that the most common reason for residual DJS was poor patient counseling on the side of the surgeon (38.16%).…”