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The forgotten double J stent. Case report of a multifractured ureter stent
K Rembrink1, M Goepel, M Meyer-Schwickerath
1Department of Urology, University of Essen Medical School, FRG.
Insights
Double J stent breakage is a rare but severe complication of ureteral stenting. Prompt diagnosis and surgical intervention are crucial for managing fractured stent fragments, emphasizing timely stent replacement.
Area of Science:
- Urology
- Medical Device Complications
- Surgical Management
Background:
- Ureteral stents are commonly used to treat urinary tract obstructions like hydronephrosis.
- Standard follow-up includes imaging to monitor stent position and function.
- Complications such as occlusion, encrustation, and migration are known risks.
Observation:
- An 81-year-old male presented with macrohematuria due to a fractured double J stent.
- The stent had been in place for 17 months, exceeding the recommended replacement interval.
- Fragments were located in the renal pelvis, ureter, and bladder.
Findings:
- Stent breakage is an uncommon yet serious complication requiring intervention.
- Combined endoscopic and open surgery was necessary for complete fragment removal.
- This case highlights the risks associated with prolonged indwelling ureteral stents.
Implications:
- Routine sonographic monitoring every 2 months is recommended for patients with ureteral stents.
- Cystography should be performed if stent malfunction is suspected.
- Ureteral stent exchange should generally occur after 12 months to prevent complications like fracture.
Abstract:
An 81-year-old male patient was admitted to hospital because of macrohematuria. The clinical examination revealed a multifractured double J stent which had been placed 17 months before in another clinic because of hydronephrosis. In the reported case, a combined endoscopic and open surgical management was necessary to remove all fragments from the renal pelvis, the ureter and the bladder. Occlusion, encrustration and migration are among the most frequent risks of ureter stenting. The breakage of the stent, however, is a rare but severe complication. Therefore, patients should generally be controlled by sonography every 2 months and when malfunction of the stent is suspected, a cystogram should follow. In general, a stent exchange should be performed after 12 months.