Strategy to track double-J stents placed during COVID-19 using smartphone-based stent tracker application to prevent forgotten double-J stent in a high-volume centre: a smart solution

Abstract

Background Forgotten or retained (double-J) DJ stents may lead to several complications. Management of retained DJ stents poses a challenge for urologists not just surgically but also medicolegally and adds to the economic burden of the patient. Difficulty in follow-up for patients due to the contagious nature of COVID-19 and several restrictions posed in the form of lockdown. Smartphones today have become an integral part of our daily lives providing a convenient and reliable platform for data storage and access. Methods All patients requiring placement of DJ stents and agreeing to enrol in the study were registered on the application over the physicians smartphone. SMSs regarding dates for removal of stent and follow-up with the literature regarding stent care were sent to the patients in their regional language. Results A total of 100 patients were stented during this period of 3 months. Mean age was 42.61 years with three patients of paediatric age group. Mean duration of stent was 6 weeks. All patients received periodic messages (average 3) regarding follow-up and date for stent removal. 3%(n = 3) patients were delayed for follow-up; 2% (n = 2) patients lost to follow-up, compared to a 9% to 10% loss to follow-up in patients followed up only on paper discharges in our department previously. Conclusion It significantly reduced the number of physical visits of the patient to the hospital and provided a more streamlined tracking of the indwelling stents for the user; patient compliance was found to be almost 98%; being cloud based (android/iOS), it was easily accessible to the user; and with the option of sharing the account details, the patient record could be accessed by several residents from their individual devices, which significantly reduced loss to follow-up rates from 9 to 2%.

Case – An invisible stent

“…Further innovations may help resolve this issue by developing materials that are more resistant to losing their radiopaque properties. Additionally, careful communication with patients as well as timely follow-up for ureteric stent changes or removal has been shown to significantly reduce the incidence of patients with forgotten stents 17,18 .…”

Approach to Forgotten Ureteral Stents: A Single Tertiary Center Experience of 49 Cases

“…However, symptoms and complications related to ureteral stents cannot be prevented (3). Although forgotten dj stents are sometimes asymptomatic, they can cause various complications such as hematuria, obstruction, infection, migration, encrustation, kidney failure, sepsis and even death (4,5).…”