[Treatment of complicated renal colic in patients treated with indinavir: value of double J stents].
OBJECTIVE
Evaluation of the treatment of complicated ureteric stones in patients treated with indinavir.


METHODS
From March 1997 to May 1998, 10 patients (7 males, 3 females, aged 30 to 56 years), treated by triple combination therapy for HIV infection, were drained for stones attributed to indinavir (CRIXIVAN), which had become obstructive and complicated. The duration of treatment with indinavir ranged from 14 days to 2 years. No patient had a history of urological disease. One patient presented with bilateral stones. All patients presented complicated clinical features: fever in 3 cases; severe pain in 8 cases, with delayed excretion more than 4 hours on IVU in 6 cases. All stones were radiolucent except for one slightly radioopaque stone. The stone was situated in the lumbar ureter in 3 cases, iliac ureter in 1 case and pelvic ureter in 8 cases.


RESULTS
In 10 out of 11 cases, a double J stent was inserted, preceded by drainage by simple ureteric catheter (infected urine) in 1 case and by percutaneous nephrostomy (PCN) with antegrade insertion of the stent (failure of the retrograde route) in 1 case. No complementary stone fragmentation or extraction treatment was necessary after this procedure. Stents were left in place for 3 to 7 weeks. In one case, a stone of the lumbar ureter required PCN followed by extracorporeal lithotripsy.


CONCLUSIONS
In the case of complications requiring a urological procedure, insertion of a double J stent allows curative treatment of very friable indinavir stones, which are fragmented by passage of the stent.
Van Glabeke
E
E
Clinique Urologique, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
Conort
P
P
Chartier-Kastler
E
E
Desrez
G
G
Boyer
C
C
Richard
F
F
D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects*; D003085:Colic / Q000139:chemically induced* / Q000628:therapy*; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000009:adverse effects; D006679:HIV Seropositivity / Q000188:drug therapy; D006801:Humans; D019469:Indinavir / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015607:Stents; D014514:Ureteral Calculi / Q000139:chemically induced / Q000628:therapy*; D014515:Ureteral Diseases / Q000139:chemically induced* / Q000628:therapy*
D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D019469:Indinavir
Traitement des coliques néphrétiques compliquées chez les patients traités par indinavir: intérêt des endoprothèses double J.