Abstract

Case Presentation

Bilateral Severe Encrustation of Long-Term Indwelling Double-J Stents in a Young Non-Lithiasic Patient

Mohammed Amine Elafari*, Mamad Ayoub, Mohammed Amine Bibat, Maachi Youssef, Amine Slaoui, Tarik Karmouni, Abdelatif Koutani and Khalid Elkhader

Published: 30 November, -0001 | Volume 10 - Issue 1 | Pages: 013-015

Ureteral double-J stents are a commonly used device in urological practice to allow urinary drainage, avoid ureteral obstruction processes, and protect the upper urinary tract after surgical procedures. However, long indwelling time may give rise to numerous complications, such as infection, migration, and fragmentation of the stent, especially encrustation. Encrustation of stents is a well-known complication that has been closely related to the time active of the stent and can cause significant morbidity if not timely addressed. In severe cases, abundant mineral deposition can result in the development of large calculi encasing the stent and rarely progress to staghorn stones. These cases may pose challenges in terms of the extraction of the stent and may result in complex endourological intervention. The encrustation likelihood is substantially higher if stents are left forgotten or remain in place longer than the advised period. Most patients with heavily encrusted stents have symptoms including flank pain, urinary tract infection, hematuria, or obstructive uropathy, but can present without any symptoms, and this can delay the diagnosis.

Read Full Article HTML DOI: 10.29328/journal.jcmei.1001042 Cite this Article Read Full Article PDF

Keywords:

Double-J stent; Ureteral stent; Encrustation; Staghorn calculi; Vesicovaginal Fistula; Lithiasis; Holmium Laser; Lithotripsy; Flexible Ureteroscopy; Hydronephrosis

References

  1. El-Faqih SR, Shamsuddin AB, Chakrabarti A, Atassi R, Kardar AH, Osman MK, et al. Polyurethane internal ureteral stents in the treatment of stone patients: morbidity related to indwelling times. J Urol. 1991;146:1487– 1491. Available from: https://doi.org/10.1016/s0022-5347(17)38146-6
  2. Kawahara T, Ito H, Terao H, Yoshida M, Matsuzaki J. Ureteral stent encrustation, incrustation, and coloring: morbidity related to indwelling times. J Endourol. 2012;26:178–182. Available from: https://doi.org/10.1089/end.2011.0385
  3. Lam JS, Gupta M. Tips and tricks for the management of retained ureteral stents. J Endourol. 2002;16:733–741. Available from: https://doi.org/10.1089/08927790260472881
  4. Bultitude MF, Tiptaft RC, Glass JM, Dasgupta P. Management of encrusted ureteral stents impacted in the upper tract. Urology. 2003;62:622–626. Available from: https://doi.org/10.1016/s0090-4295(03)00506-5
  5. Acosta-Miranda AM, Milner J, Turk TM. The FECal Double-J classification: a simplified approach in the management of encrusted and retained ureteral stents. J Endourol. 2009;23:409–415. Available from: https://doi.org/10.1089/end.2008.0214

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