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Review
. 2022 Sep 5:43:5.
doi: 10.11604/pamj.2022.43.5.34538. eCollection 2022.

Knotted double j ureteral stent: a case report and literature review

Omar Jendouzi  1 , Aziz Lamghari  1 , Mounir Jamali  1 , Amine Harchaoui  1 , Mohamed Alami  1 , Ahmed Ameur  1
Affiliations
Review

Knotted double j ureteral stent: a case report and literature review

Omar Jendouzi et al. Pan Afr Med J. .

Abstract

Many complications due to double j (DJ) stent placement have been reported. DJ stent knotting is a rare complication, with only a few cases reported in the literature. We presented a case of DJ stent knotting and reviewed the literature regarding this complication. We reported a 20-year-old man with a history of cystinuria and ureteral stone managed with retrograde ureteroscopy and holmium laser three months ago. The patient comes for DJ stent removal. Firstly, we tried to remove the DJ stent via the cystoscopic procedure, which failed. A fluoroscopic image revealed a knotted DJ stent lodged at the ureteropelvic junction and was removed via holmium laser ureteroscopic procedure without complications. In conclusion, when cystoscopic procedure with simple traction fails to remove DJ stents, multimodality urological procedures such as holmium laser should be tried, especially in patients with urolithiasis predisposing factors.

Keywords: Knot ureteral stent; case report; encrustation; urological complication.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
plain radiography X-ray before stent removal: no knotting in the stent (arrow)
Figure 2
Figure 2
appearance of the knotted double-j stent on the fluoroscopic image (square)
Figure 3
Figure 3
endoscopic view of the proximal end of the stent knotted and encrusted in the pelvic ureter (arrow)
Figure 4
Figure 4
ureteral DJ stent after removal with knotted part (arrow)
See this image and copyright information in PMC

References

    1. Zimskind PD, Fetter TR, Wilkerson JL. Clinical use of long-term indwelling silicone rubber ureteral splints inserted cystoscopically. J Urol. 1967 May;97(5):840–4. - PubMed
    1. Picozzi S, Carmignani L. A knotted ureteral stent: a case report and review of the literature. Urol Ann. 2010 May;2(2):80–2. - PMC - PubMed
    1. Ahmed F, Al-wageeh S, Ghabisha S, Al-shami E, Al-naggar K, Obaid G, et al. A case report of forgotten double J stent with giant calculus formation from the renal pelvis to the bladder. JEMTAC. 2021;2021(3)
    1. Groeneveld AE. The role of ESWL in the treatment of large kidney stones. Singapore Med J. 1989 Jun;30(3):249–54. - PubMed
    1. Bhirud P, Giridhar V, Hegde P. Midureteric knotted stent removed by percutaneous access. Urol Ann. 2012 May;4(2):106–7. - PMC - PubMed