Calcified double-J stent: Case report and review of recent literature

Double-J ureteral stents are widely used in urology for urinary drainage, but prolonged retention can lead to complications such as encrustation and calcification. This review aims to analyze the current literature on calcified Double-J stents, with a focus on management strategies and patient outcomes.

We report two cases of long-term retained Double-J stents with significant calcification. The first case involves a 45-year-old man who had a stent in place for seven years, leading to complete fragmentation and extensive encrustation at multiple levels. He underwent combined ureteroscopy for renal and ureteral fragments and open cystolithotomy for a large bladder stone. The second case concerns a 32-year-old man with a history of ureteropelvic junction obstruction, who retained his stent for 14 months after a previous episode of stent-related bladder stone formation. He required repeat cystolithotomy and definitive surgical correction of his obstruction due to poor compliance.

The review of current literature and our case series emphasize the complexity of managing calcified Double-J stents, which often necessitate multimodal treatment. Endoscopic approaches, including ureteroscopy and percutaneous techniques, are preferred for most cases, but severe encrustations may require open surgery. Factors influencing management decisions include the degree of calcification, anatomical considerations, and patient compliance. Prevention strategies, such as stent-tracking systems and patient education, play a crucial role in reducing complications.

The management of calcified Double-J stents requires an individualized approach, balancing minimally invasive techniques with the need for definitive intervention. Early detection and timely removal of indwelling stents are critical to prevent complications and improve patient outcomes.