title: The indwelling ureteric stent: a 'friendly' procedure with unfriendly high morbidity.
abstract: OBJECTIVE
  To review the morbidity and complications of ureteric stent insertion and to evaluate specifically the effect of an indwelling ureteric stent on the changes in hydronephrosis after stenting.
  
  
  METHODS
  In a prospective study, 110 renal units with a stent in place were evaluated in 90 patients. Of the 110 stents, 52 were left in place for 3 months, 23 for 6, 11 for 9, 19 for 12 and five (forgotten stents) for 13-30 months. The patients were followed using plain abdominal X-ray at 1 and 30 days after stenting. They were further followed using ultrasonography and plain films every 3 months until the scheduled date for stent removal or the appearance of complications.
  
  
  RESULTS
  Thirty-four patients had fever and bacteriuria after stent insertion. Of the 110 stents, 11 (10%) fragmented and nine (8%) migrated. Seventeen patients complained of flank pain on voiding. In 21 renal units (19%) there was no change in the severity of hydronephrosis, whereas in six (5.5%) hydronephrosis developed or worsened after stenting.
  
  
  CONCLUSIONS
  Although ureteric stenting is undoubtedly an important procedure to relieve ureteric obstruction, the indications for stent insertion should be considered carefully in every patient. The close follow-up of stented patients is valuable for the early detection of morbidity or complications and in such cases the stent should be removed or exchanged as soon as possible.
authors.affiliation: Department of Urology, Sapir Medical Center, Kfar Sava, Sackler Faculty of Medicine, University of Tel Aviv, Israel. sanri@netvision.net.il
authors.forename: S
authors.initials: S
authors.lastname: Richter
authors.forename: A
authors.initials: A
authors.lastname: Ringel
authors.forename: M
authors.initials: M
authors.lastname: Shalev
authors.forename: I
authors.initials: I
authors.lastname: Nissenkorn
mesh_terms: D002408:Catheters, Indwelling / Q000009:adverse effects; D004868:Equipment Failure; D005260:Female; D005548:Foreign-Body Migration / Q000150:complications; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology; D008297:Male; D011446:Prospective Studies; D015607:Stents / Q000009:adverse effects*; D014517:Ureteral Obstruction / Q000628:therapy*; D014546:Urinary Catheterization / Q000009:adverse effects*; D014718:Vesico-Ureteral Reflux / Q000209:etiology