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Can the complicated forgotten indwelling ureteric stents be lethal?
V Singh1, A Srinivastava, R Kapoor
1Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Science, Lucknow, India. vishwajeeturo@sify.com
International Urology and Nephrology
|November 25, 2005
Summary
Forgotten ureteral stents pose a serious urological challenge. Management requires advanced endourological techniques and lithotripsy to prevent potentially lethal complications from encrusted or fragmented stents.
Area of Science:
- Urology
- Endourology
- Nephrology
Background:
- Forgotten ureteral stents present significant clinical challenges, often leading to severe complications.
- Management strategies for these stents typically involve lithotripsy and endourological interventions.
Observation:
- A retrospective review of 19 patients with forgotten ureteral stents (duration 7 months to 10 years) was conducted.
- Complications included severe calcification, encrustation, large stone formation, spontaneous fragmentation, hydroureteronephrosis, and infected hydronephrosis.
Findings:
- Uncomplicated stents were removed retrograde. Severely calcified stents required retrograde removal, percutaneous nephrostomy, or fragmentation.
- Stones associated with stents were managed with lithotripsy (mechanical or laser) and retrograde removal.
- Two patients with severe complications (renal failure, infected hydronephrosis) died due to their condition or operative intervention.
Implications:
- Judicious application of endourological techniques and lithotripsy is crucial for managing complicated forgotten ureteral stents.
- Stent-related complications can be directly lethal or indirectly cause mortality through operative intervention complications.