The forgotten indwelling ureteral stent: a urological dilemma.
Ureteral stents are an integral part of urological practice. However, stents that migrate, fragment or are forgotten pose a management and legal dilemma. Our series consists of 31 patients, 22 with forgotten stents that were left indwelling for more than 6 months (mean 22.7) and 9 migrated stents. Of the forgotten stents 15 (68%) were calcified, 10 (45%) were fragmented, and 3 (14%) were calcified and fragmented. Procedures to render the patient stent-free were ureteroscopy in 16 (52%), percutaneous nephroscopy in 8 (26%), cystoscopic electrohydraulic lithotripsy in 6 (19%), extracorporeal shock wave lithotripsy in 10 (32%), open cysto-litholapaxy in 1 (3%) and simple nephrectomy in 1 (3%). Multiple procedures were required in 6 patients (19%). Management of such complicated ureteral stents requires a multimodal therapeutic approach incorporating the latest in extracorporeal shock wave lithotripsy and endourological techniques. These patients are at increased risk for loss of renal function. A computerized tracking registry of ureteral stents may help prevent this urological travesty.
Monga
M
M
Department of Urology, Tulane University School of Medicine, New Orleans, Louisiana, USA.
Klein
E
E
Castañeda-Zúñiga
W R
WR
Thomas
R
R
D000328:Adult; D002408:Catheters, Indwelling; D005547:Foreign Bodies / Q000628:therapy*; D006801:Humans; D007049:Iatrogenic Disease; D008096:Lithotripsy; D008297:Male; D012189:Retrospective Studies; D015607:Stents; D014513:Ureter; D014546:Urinary Catheterization / Q000295:instrumentation*