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. 2023 May;41(5):1415-1421.
doi: 10.1007/s00345-023-04361-8. Epub 2023 Apr 6.

Endoscopic management of encrusted ureteral stents: outcomes and tips and tricks

Arman Tsaturyan  1   2 , Gabriel Faria-Costa  3   4 , Angelis Peteinaris  5 , Marco Lattarulo  5 , Begona Ballesta Martinez  5 , Theofanis Vrettos  6 , Evangelos Liatsikos  5   7 , Panagiotis Kallidonis  5
Affiliations

Endoscopic management of encrusted ureteral stents: outcomes and tips and tricks

Arman Tsaturyan et al. World J Urol. 2023 May.

Abstract

Purpose: To report our experience in the management of encrusted ureteral stents (EUS) and provide technical insight of our endourological approaches for difficult scenarios posed by this entity.

Materials and methods: A retrospective evaluation of a longitudinally collected database of 58 patients with encrusted US between December 2012 and May 2022 was performed. The ureteral stents were initially inserted due to obstructive uropathy, pyelonephritis or after a successful endoscopic procedure for urolithiasis. A combination of antegrade/retrograde treatment in single or multiple sessions took place for the retrieval of the encrusted stents. Non-contrast enhanced computer tomography was used for the follow-up of the patients at 1-month after the removal of the encrusted stent.

Results: Overall 58 patients, 39 males and 19 females with a median age of 51 years old were included in the study. Indwelling time was < 6 months, 6-12 months and > 12 months in 22%, 57% and 21% of the cases, respectively. All US were successfully removed. Semi-rigid ureteroscopy (URS) and flexible ureteroscopy (fURS) were used in 90% of the cases. In 10% of the cases, a second-stage percutaneous nephrolithotomy (PCNL) or endoscopic combined intrarenal surgery (ECIRS) was performed. All US were successfully released. Stone-free rate was 84% at 1-month. Overall complication rate was 10.5% (mostly postoperative fevers, 5.4%).

Conclusion: Removal of the encrusted US is a challenging procedure. Appropriate decision-making and knowledge of specific tricks may result in safe and successful management of significant EUS.

Keywords: Encrusted stent; Endoscopic combined intrarenal surgery; Forgotten ureteral stents; Management of ureteral stents; Ureterorenoscopy.

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