Management of Forgotten Ureteral Stents: Relationship Between Indwelling Time and Required Treatment Approaches

Abstract

Background: Double-J stents are widely used in urology practice, and removal of these stents can sometimes be forgotten.

Aims: To investigate whether indwelling time of double-J stent can predict which treatment modality is required for removal of the stent from the body.

Study design: A multicentre, retrospective observational study.

Methods: The data of 57 patients who were treated for forgotten ureteral stents between January 2007 and December 2014 were evaluated retrospectively. Patients were classified into four groups according to indwelling time of the stents: 6-12 months, 13-24 months, 25-36 months, and <36 months. Encrustation and associated stone burden of the stents were evaluated with non-contrast stone protocol computerised tomography.

Results: Patients were classified according to their duration of the stent indwelling time. Simple cystoscopic stent retrieval was performed in 71.4% of patients in the 6-12 months group, 44% of patients in the 13-24 months group, 6.2% of patients in the 25-36 months group, and 11.1% of patients in the <36 months group. A percutaneous or open surgery was required in no patients with an indwelling time of double-J stent shorter than 30 months.

Conclusion: Transurethral and/or percutaneous combined endo-urological approaches are usually sufficient for the removal of forgotten double-J stents. Transurethral procedures are sufficient for the treatment of patients with double-J stent indwelling times less than 30 months.

Keywords: Disease management; foreign bodies; urinary catheters urolithiasis..

Figure 1. Stone burden was increased in parallel with indwelling time of stent.

Figure 2. a-d. Some images of a patient whose double-J stent had remained in the body for 30 months. Thickened stent due to encrustation (a). Encrustations and stones on computerised tomography, which were not seen in the KUB radiograph (b). Encrustation on the stent; stent was removed by ureteroscopy (c). A new stent inserted in the same patient at the same calibration (6 Fr.) (d). Notice the difference between this new stent and the thickened encrusted stent.