A case of pyonephrosis secondary to ureteral stent calculus

Abstract

Ureteric stents, a good solution to many urologic problems, can lead to significant morbidity if left in situ longer than required. Our case is that of an elderly male with a history of intractable hypertension presenting with urosepsis, anemia, diabetes and chronic renal failure. His work-up revealed a stent in the right kidney with secondary staghorn calcification in the renal pelvis and a large vesical calculus. He had apparently undergone stent placement 12 years previously, but was lost to follow-up due to relocation. A nuclear scan revealed a complete loss of renal function. Cystoscopic stent removal was futile, so he underwent an elective right subcapsular nephrectomy. The specimen revealed pyonephrosis with loculations of pus. Postoperatively his course was uneventful, with the hypertension resolving in 4 weeks.