Bostanci Y et al, 2011: Single session removal of forgotten encrusted ureteral stents: combined endourological approach
Bostanci Y, Ozden E, Atac F, Yakupoglu YK, Yilmaz AF, Sarikaya S
Department of Urology, Faculty of Medicine, Ondokuz Mayis University, Kurupelit, 55139, Samsun, Turkey
Abstract
Forgotten ureteral stents represent a difficult problem for urologists; the major complications are infection, migration, encrustation, stone formation, and multifractured stent, and a consensus on the best therapeutic approach is lacking. Here we present our experience with endoscopic management of this challenging problem and discuss the various endourological approaches for treating forgotten encrusted ureteral stents. From January 2005 to December 2010, 19 patients (11 women and 8 men) with encrusted ureteral stents were retrospectively analyzed. Combined endourologic therapies including extracorporeal shock wave lithotripsy (SWL), percutaneous nephrolithotomy (PCNL), ureterorenoscopic lithotripsy (URSL), and cystolithotripsy (CLT) were used to achieve stent removal. A total of 19 patients with encrusted ureteral stents were treated at our center. The mean patient age was 46.2 ± 18.5 years (8-81), the average indwelling time of the stent was 24.7 ± 19.0 months (8-93), and the mean hospital stay was 3.4 ± 4.0 days (range 1-15 days). Using the described combination of techniques, all stents and the associated stones were eventually removed without any complications and patients were rendered stone- and stent-free. A main element of the treatment strategy was to keep the number of interventions as low as possible. The use of various combinations of endourological techniques can achieve effective stent and stone treatment after a single anesthesia session with minimal morbidity and short hospital stay.
Urol Res. 2012 Oct;40(5):523-9. doi: 10.1007/s00240-011-0442-2. Epub 2011 Dec 11
PMID:22160282 [PubMed - as supplied by publisher]
Comments 1
The authors present an algorithm on the treatment of forgotten incrusted stents based on their experience with 19 cases. With the combinations of various endourological techniques they were successful with a single anesthesia session only. SWL was applied in only 4 cases initially and in 3 cases for residual stones.
Peter Alken