A rare complication of ureteral stent removal: Questions

Objective: We examined the outcomes of patients undergoing ureteral stent placement for hydronephrosis that occurred during treatment for gynecological malignancies. Materials and Methods: From January 2004 to December 2009, we enrolled 33 patients with 45 ureters undergoing ureteral stent placement for hydronephrosis which occurred during treatment for gynecological malignancies. We examined the outcomes of the patients after stent placement. Results: The causes of hydronephrosis were obstruction of the urinary tract by a tumor (n = 22), obstruction due to lymph node swelling (n = 6), ureteral stenosis after radiation therapy (n = 4), and others (n = 1). The ureteral stent was inserted into both ureters in 12 cases, and into one ureter in 21 cases. Ureteral stents were replaced 1-26 times during the observation period (median 3 times). Eighteen (40%) ureteral stents were removed. The reasons for ureteral stent removal were hydronephrosis improvement (11 ureters, 24.4%), a change to nephrostomy (cystectomy: 1 ureter, progression of ureteral stenosis: 2 ureters), renal atrophy (3 ureters), and ureteral dilatation (1 ureter). All of the cases in which ureteral stent withdrawal due to hydronephrosis improvement were cases in which the ureter was compressed by a tumor and were lower ureteral obstructions. Twenty-one patients (64%) died due to cancer after stent placement. The periods from the first stent placement to death ranged from 1 to 58 months (median 18 months). Conclusion: Ureteral stent placement was associated with a poor prognosis in patients with gynecological malignancies. There were a few cases in which stent withdrawal became possible due to the improvement of hydronephrosis. In such cases, the withdrawal rate varied according to the cause and obstructive level.

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PD7-08 PATIENT EXPERIENCES AND PREFERENCES WITH URETERAL STENT REMOVAL TECHNIQUES

The Journal of Urology ◽

10.1016/j.juro.2014.02.697 ◽

2014 ◽

Vol 191 (4S) ◽

Author(s):

Mike Nguyen ◽

Roger Low ◽

Manoj Monga

Keyword(s):

Patient Experiences ◽

Ureteral Stent ◽

Stent Removal

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PD31-05 TITLE: PAIN FOLLOWING URETERAL STENT REMOVAL: PREVALENCE AND TREATMENT

The Journal of Urology ◽

10.1016/j.juro.2016.02.549 ◽

2016 ◽

Vol 195 (4S) ◽

Author(s):

Gabriel Belanger ◽

Lisa Beaule

Keyword(s):

Ureteral Stent ◽

Stent Removal

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SPONTANEOUS RUPTURE OF DOUBLE J URETERAL STENT

Journal of Surgical Sciences ◽

10.33695/jss.v7i3.396 ◽

2020 ◽

Vol 7 (3) ◽

pp. 114-116

Author(s):

Abdi El Mostapha ◽

Ghannam Youssef ◽

Hissein Hagguir ◽

Nedjim Abdelkerim Saleh ◽

Dakir Mohamed ◽

...

Keyword(s):

Ureteropelvic Junction Obstruction ◽

Stone Formation ◽

Rare Complication ◽

Percutaneous Nephrostomy ◽

Ureteral Stent ◽

Vaginal Examination ◽

Ureteral Stenosis ◽

Long Duration ◽

Double J Stent ◽

Obstructive Renal Failure

The double J stent is widely used in urological endoscopic surgery with different indications (ureteral stenosis, ureteropelvic junction obstruction, retroperitoneal tumor or fibrosis) and can be a subject to multiple complications including migration, encrustation, stone formation and fragmentation which is a rare complication. We are reporting a rare case of a 42-years-old, followed for cervical cancer since 2018 revealed by an acute obstructive renal failure drained by a left double J ureteral stent (of long duration) and right percutaneous nephrostomy. The patient maintained the double J stent for 2 years. On clinical examination there was a lumbar tenderness on the left side and a hardened vaginal cervix on bimanual vaginal examination. The patient underwent a renovesical ultrasound showing a minimal left ureterohydronephrosis. The uroscanner with reconstruction revealed a fragmented double J stent on the left side.

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Novel method to decrease the exposure time of the extraction string of the ureteral stent and its efficiency and safety verification in the clinic

Scientific Reports ◽

10.1038/s41598-021-01821-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

WenGang Hu ◽

YaJun Song ◽

Yang Li ◽

YueHua Li ◽

Jiao Mu ◽

...

Keyword(s):

Exposure Time ◽

Medical Costs ◽

Demographic Characteristics ◽

Ureteral Stent ◽

Continuous Exposure ◽

The Novel ◽

Ureteral Stents ◽

Stent Removal ◽

Significant Difference ◽

Novel Method

AbstractUreteral stent removal by an extraction string is advantageous. However, the increased risk of complications attributed to the continuous exposure of the string outside the urethra must be managed. This paper introduces a method to decrease the exposure time, and conducts a retrospective study to verify its efficiency and safety. A total of 231 male patients undergoing routine ureteroscopy (URS) were included, and all of them accepted indwelling ureteral stents with strings. Among them, 123 patients (Normal-S group) underwent the normal method to determine the length of string (Lstring), which was shortened to 4 cm (cm) past the urethral meatus; 108 patients (Novel-S group) underwent the novel method (Lstring = Lurethra + 2 cm), the length of urethra (Lurethra) was measured during ureteroscopy by ureteroscope body. The demographic characteristics, stent indwelling and removal-related variables, complications, and medical costs in each group were recorded. There was no significant difference in demographic characteristics, the rate of UTI, the operative duration of URS, or the VAS pain scores for stent removal between the 2 groups. For the Novel-S group, the stent dwelling time was longer, the self-rated discomfort and symptom, the stent dislodgement rate, the numbers of clinic or emergency visits and the overall medical cost post operation was lower in comparison with the Normal-S group, while the rate of removal of stents by hand was lower, the time for removing ureteral stents was longer. This novel method improved stenting comfort, avoided ureteral stent dislodgement, decreased complications, and lowered medical costs, it was safe and reliable and merits widespread application.

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