Management of forgotten or retained indwelling ureteral stents

Five patients presented with forgotten or retained stents, and a plan of management for this complication is described. Stents were in place from 1 to 7 years. We developed an algorithm for evaluating and treating these complications. All patients should have intravenous urogram to determine function and to identify any obstruction. If there is no stent encrustation, a simple extraction under fluoroscopic control can be attempted. If significant stent calcification is present, extracorporeal shock-wave lithotripsy may be tried first. Open procedures are reserved for those patients with more than 3 mm of stent encrustation extending throughout the length of the stent, or with large volume upper tract calcification. For minimally calcified stents or for those stents with upper curls that will not straighten out on gentle traction, percutaneous extraction can be attempted in the radiology suite. If this is unsuccessful, then percutaneous nephrostolithotomy is the next step.