Loss of structural integrity of a coil based ureteral stent

We present the first reported complication of the Silhouette, (Applied Medical, Santa Margarita, CA) 4 Fr. soft, nitinol coil-reinforced double-J ureteral stent, that is specifically related to its unique construct and design. These novel ureteral stents were placed in a medically unstable patient with bilateral partially obstructing proximal ureteral calculi. At the time of ureteroscopy, it was noted that a mild to moderate amount of encrustation was present on the distal curl of the ureteral stent. Upon removal of the stent, resistance was encountered and disintegration and fragmentation of the stent was noted. The patient eventually underwent staged ureteroscopy and shock wave lithotripsy (SWL) to remove the remaining portions of the encrusted ureteral stent.