Fragmentation of Severely Encrusted Ureteral Stent Indwelled for 4 Years in a Boy

Area of Science:

• Pediatric Urology
• Nephrolithiasis Management
• Minimally Invasive Surgery

Background:

• A 9-year-old boy underwent percutaneous nephrolithotomy (PCNL) with double-J stent (DJS) placement.
• The DJS was subsequently neglected for four years, leading to severe complications.

Observation:

• Complications included extensive stent encrustation, a large 5-cm vesical calculus, DJS fragmentation, and a serious urinary tract infection.
• This represented a rare and complex case of pediatric lithiasis and stent mismanagement.

Findings:

• A combined approach utilizing PCNL and suprapubic cystolithotomy was employed for complete stone and stent removal.
• The procedure was performed without any intraoperative or postoperative complications.

Implications:

• This case highlights the critical importance of timely stent removal and follow-up in pediatric patients.
• The successful combined surgical strategy offers a safe and effective solution for managing complex encrusted ureteral stents and associated bladder stones in children.