Treatment of retained encrusted ureteral Double-J stent

Ibrahim Alnadhari, Mohammed Ahmed Alwan, M. Salah, Abdulelah M. Ghilan

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: We conducted this study to evaluate patients with retained encrusted ureteral stents, identify the predisposing factors and present our experience in the management of such challenging problem. MATERIALS AND METHODS: This prospective study was carried out in the period from May 2007 to February 2011 at the Urology and Nephrology Center, Al-Thawra General Hospital, Sana'a, Yemen. 40 patients with retained encrusted ureteric stents were treated at our center. All patients were initially evaluated with a radiographic imaging for assessment of stent encrustation and stone burden. Treatment decisions were based on the site and severity of encrustations in the renal pelvis, ureter and bladder and on our technical situation and availability of instrumentations. Multi-modal approaches ranging from extracorporeal shock wave lithotripsy (ESWL) to endourological and open urologic procedures were used to achieve stent removal. RESULTS: A total of 90 urological procedures were performed to render all 40 patients stent and stone free. The average duration of stent remained indwelling was 24.2 months (range 4 months -16 years). All patients were managed either by minimally or more invasive multi-modal endourological approaches. For upper coil encrustation percutaneous nephrolithotripsy was performed in eight patients, pyelolithotomy in two patients and ESWL in three patients. Encrustation of the body was treated initially by ESWL, followed by retrograde ureteroscopic manipulation in 12 patients. Lower coil encrustation was successfully managed by cystolitholapaxy in seven patients and one patient required cystolithotomy. Cystolithotomy, pyelolithotomy and ureterolithotomy were carried out in two patients. Two patients who had large burden bladder and kidney stones with loss of kidney function underwent nephrectomy and cystolithotomy. CONCLUSIONS: The retrieval of severely encrusted retained ureteral stent and its associated stone burden poses a real management challenge for urologists due to the need for multimodal procedures and the lack of standardized treatment plan.

Original languageEnglish
Pages (from-to)265-269
Number of pages5
JournalArchivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica
Volume90
Issue number4
DOIs
Publication statusPublished - Jan 18 2019

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Stents
Lithotripsy
Therapeutics
Yemen
Urinary Bladder Calculi
Kidney Pelvis
Kidney Calculi
Nephrology
Urology
Ureter
Nephrectomy
General Hospitals
Causality
Urinary Bladder
Prospective Studies
Kidney

ASJC Scopus subject areas

  • Urology

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Treatment of retained encrusted ureteral Double-J stent. / Alnadhari, Ibrahim; Alwan, Mohammed Ahmed; Salah, M.; Ghilan, Abdulelah M.

In: Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica, Vol. 90, No. 4, 18.01.2019, p. 265-269.

Research output: Contribution to journalArticle

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