Spontaneous Ureteral Stent Fragmentation

Zisman, Amnon; Siegel, Yoel; Siegmann, A.; Lindner, Arie

doi:10.1016/s0022-5347(01)67697-3

Cited by 59 publications

(45 citation statements)

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“…For stents with large stone burden and those stents which fail to be retrieved by the above-menof tensile strength, which is due to hardening and degeneration of the stent polymers (22). The risk of encrustation and fragmentation is dependant on the type of material of the stent.…”

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confidence: 99%

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Endourological Management of Forgotten Encrusted Ureteral Stents

2010

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Purpose: To present our experience and discuss the various endourological approaches for treating forgotten encrusted ureteral stents associated with stone formation. Materials and Methods: From July 2006 to December 2008, 14 patients (11 men and 3 women) with encrusted ureteral stents were analyzed. The average indwelling time of the stent was 4.9 years (range 1 to 12). Plain-film radiography was used to evaluate encrustation, stone burden, and fragmentation of the stents. Intravenous urogram and a Tc99m diethylene triamine penta acetic-acid renogram was used to assess renal function. Results: In seven patients, the entire stent was encrusted, in three patients the encrustation was confined to the ureteral and lower coil part of the stent, two patients had encrustation of the lower coil, and minimal encrustation was observed in two patients. Percutaneous nephrolithotomy was performed in 5 cases and retrograde ureteroscopy with intra-corporeal lithotripsy in 9 patients. Cystolithotripsy was used to manage the distal coil of the encrusted stent in eight patients. Simple cystoscopic removal of the stents with minimal encrustation was carried-out in two cases. Looposcopy and removal of the stent was performed in one patient with an ileal conduit and retained stent. Only one patient required open surgical removal of the stent. Thirteen out of 14 patients were rendered stone and stent free in one session. All except two stents were removed intact and stone analysis of encrustation and calcification revealed calcium oxalate and calcium phosphate in the majority of the cases. Conclusion: Endourological management of forgotten encrusted stents is highly successful and often avoids the need for open surgical techniques.

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“…They concluded that, these stents can be removed in one sitting with minimal morbidity and short hospital stay (25). Using a combination of SWL, PCNL, CLT, ureteroscopy with intra corporeal lithotripsy, clearance rates ranging from 75 to 100% have been reported (10,12,22).…”

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Endourological Management of Forgotten Encrusted Ureteral Stents

2010

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“…Las complicaciones más frecuentes del olvido de estos catéteres son la fragmentación, la calcificación y formación de cálculos y en casos extremos la incorporación del mismo a la pared ureteral 6 . La fragmentación puede producirse incluso en catéteres que llevan colocados un perí-odo breve de tiempo 4,7 . En cualquier caso, para extraer el catéter se necesita una maniobra combinada de abordaje percutáneo para extraer el extremo superior y además una ureteroscopia o cistoscopia para extraer el inferior [7][8] .…”

Section: Discussionunclassified

“…La fragmentación puede producirse incluso en catéteres que llevan colocados un perí-odo breve de tiempo 4,7 . En cualquier caso, para extraer el catéter se necesita una maniobra combinada de abordaje percutáneo para extraer el extremo superior y además una ureteroscopia o cistoscopia para extraer el inferior [7][8] . Sin embargo, en ocasiones debido a que la fragmentación es múltiple o a la adherencia del catéter a la mucosa ureteral ha de recurrirse a la cirugía abierta 6,9 .…”

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Extracción asistida mediante litotricia extracorpórea de un catéter ureteral calcificado olvidado 2 años

et al. 2003

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RESUMEN"EXTRACCIÓN ASISTIDA MEDIANTE LITOTRICIA EXTRACORPÓREA DE UN CATÉTER URETERAL CALCIFICADO OLVIDADO 2 AÑOS" Se presenta el caso de un varón de 45 años que llevaba olvidado durante 2 años un catéter ureteral doble J izquierdo. El catéter presentaba ambos extremos calcificados no pudiéndose extraer mediante cistoscopia y pinzas. Se realizaron sesiones de litotricia extracorpórea en ambos extremos consiguiéndose la fragmentación de la litiasis y posteriormente pudo ser extraído en dos trozos mediante cistoscopia y ureteroscopia.PALABRAS CLAVE: Catéter ureteral. Calcificación. Litotricia extracorpórea. ABSTRACT "EXTRACORPOREAL WAVE LITHOTRIPSY ASSISTED DRAWING OF A CALCIFIED URETERALSTENT LEFT OUT FOR TWO YEARS" A 45 year old man with a 2 year forgotten left double-pigtail ureteric stent was referred to our hospital. Because of distal calcifications, the stent could not be removed by means of a cystoscopy. So, extracorporeal wave lithotripsies were performed and then the stent were easily removed in two fragments by cystoscopy and ureteroscopy. N NO OT TA A C CL LÍ ÍN NI IC CA A E l uso de catéteres ureterales tipo doble J es de gran utilidad en el tratamiento de la obstrucción ureteral. Sin embargo, ha de asumirse que la colocación de este tipo de catéteres no está exenta de problemas ya que hay pacientes que pueden presentar problemas de tolerancia y también desarrollar complicaciones como la fragmentación, la migración o la calcificación del catéter. No obstante, debido a la gran utilización de estos catéteres surge un nuevo problema que es el hecho de que se deje olvidado en el uréter. En este caso, no se es consciente del olvido hasta que se halla el catéter en un control rutinario o cuando empieza a causar síntomas debido a alguna complicación asociada. Una de las complicaciones más frecuentes es la calcificación e incluso la formación de litiasis en los extremos libres del caté-ter, tal como ocurrió en el caso clínico que se presenta. En esta situación, pensamos que la realización de litotricia extracorpórea con el fin de fragmentar la litiasis favorece extraordinariamente la extracción ulterior del catéter.

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“…Bu kullanım sıklığı nedeniyle bu stentlere bağlı komplikasyonlar artık daha sık görülmektedir [1]. Migrasyon, kırılma ve kırılan parçaların kalsifikasyonu sıklıkla bildirilmektedir [2][3][4]. Unutulan üreteral stentlere bağlı olarak şiddetli enkrustasyonlar, büyük taş oluşumu, tekrarlayan üriner sistem enfeksiyonları, hematüri ve hatta böbrek fonksiyonlarında geri dönüşümsüz bozulmalar görülebilmektedir [2][3][4][5][6].…”

Section: Introductionunclassified

Post-Traumatic Retroperitoneal Hematoma in a Patient with Solitary Kidney and Forgotten Ureteral Stent

Aldemir¹

2011

Ann Clin Anal Med

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ÖzetÜreteral stentler üroloji pratiğinde sık kullanılmaktadırlar. Unutulan üreteral stentlere bağlı olarak şiddetli enkrustasyonlar, büyük taş oluşumu, tekrarlayan üriner sistem enfeksiyonları, hematüri ve böbrek fonksiyonlarında bozulmalar görülebil-mektedir. Bu makalede, travma sonrası retroperitoneal kanama ile acil polikliniğe başvuran, incelemeler sonrası sol soliter böbreğinde 5 yıl unutulmuş üreteral stenti bulunan olgu tartışıldı. Direkt üriner sistem grafisi ve bilgisayarlı batın tomografisi ile görüntülenen opasitelerin unutulmuş üreteral stente ait olduğu anamnez ile anlaşılabildi. Üreteral stent konulan hastalara stentin alınması ile ilgili bilgi verilmeli ve bu hastalar sıkı bir şekilde takip edilmelidir. Gelişmiş teknolojik tanı yöntemlerinin tıbbi öykünün yerini alamayacağı da unutulmamalıdır. Anahtar KelimelerSoliter Böbrek, Unutulmuş Üreteral Stent, Travma, Retroperitoneal Hemotom. AbstractUreteral stents are frequently used in urology practice. If forgotten to be removed, they might lead to recurrent urinary tract infections, hematuria, formation of encrustations and stones and irreversible deterioration of the kidney function. Herein, we present a patient who was diagnosed with left retroperitoneal hematoma following trauma who admitted to emergency department. Radiological evaluations including kidney-ureter-bladder x-ray and abdominal computerized tomography demonstrated a left ureteral stent in the kidney. History of the patient confirmed the presence of the ureteral stent which was inserted five years ago and has been forgotten to be removed. Following insertion of the uretereal stents, patients must be informed regarding the necessity of the removal of the stent after certain duration of time and these patients should be follow-up cautiously.History taking is a very important part of patient evaluation despite the presence of technological diagnostic advances and tools.

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Spontaneous Ureteral Stent Fragmentation

Cited by 59 publications

References 10 publications

Endourological Management of Forgotten Encrusted Ureteral Stents

Endourological Management of Forgotten Encrusted Ureteral Stents

Extracción asistida mediante litotricia extracorpórea de un catéter ureteral calcificado olvidado 2 años

Post-Traumatic Retroperitoneal Hematoma in a Patient with Solitary Kidney and Forgotten Ureteral Stent

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