[Double-J ureteral catheter: a method without complications?]

Since 1978, 90 patients with hydronephrosis due to ureteral obstruction have been treated with indwelling double-J ureteral stents (104 Renoureteral units). In cases of temporary treatment (e.g. infected hydronephrosis) splints were left in situ between 1 week and 19 months (mean 15 weeks). If permanent ureteral splinting was necessary as a palliative measure (e.g. progressive carcinoma of pelvic organs) stents were left in situ 6 months up to 5 years (mean 16 months). Replacement of the indwelling double-J stents was carried out in 4 to 12 weeks intervals. The all-over complication rate was near 11% including kidney stone formation in 6 cases and septicaemia due to a clogged stents and pyonephrosis in 3 cases. In two cases after pelvic radiotherapy severe hemorrhage occurred due to erosion of the commun iliac artery. The catheters had been left in situ for 28 and 30 months. Relief of obstruction by indwelling ureteral stents in the majority of the patients can simply be achieved usually without severe technical problems. Nevertheless, a 11% complication rate require restriction to indication especially in cases of long term treatment and after radiotherapy. Urinary diversion by percutaneous nephrostomy is the method of choice to avoid disadvantage of indwelling ureteral splinting.