title: The forgotten ureteral stent in children: from diagnosis to treatment.
abstract: OBJECTIVE
  We conducted a multicenter pediatric study of ureteral stents unintentionally left in situ.
  
  
  METHODS
  A total of 22 patients with encrusted Double-J® ureteral stents unintentionally left in situ were treated at 4 centers between January 2007 and March 2012. Stone burdens were estimated using plain radiography and computerized tomography. Treatment decision was made based on clinical and radiological findings or stone burden.
  
  
  RESULTS
  Nine girls and 13 boys with a mean age of 9.5 years (range 2 to 16) were analyzed. Mean indwelling time of ureteral stent was 21.7 months (range 6 to 60). Stents were inserted for the indication of urolithiasis (17 patients) and reconstructive urological intervention (5). In 2 patients stents had been placed bilaterally. Mean stent stone burden was 184 mm(2) on plain radiography and 247 mm(2) on computerized tomography, a difference that was statistically significant (p = 0.002). Shock wave lithotripsy was done in 6 cases. Endoscopic procedures were performed in all patients, including ureteroscopy in 8, simple stent removal in 7, endoscopic cystolithotripsy in 6, percutaneous nephrolithotomy in 5, retrograde intrarenal surgery in 3 and percutaneous cystolithotripsy in 2. Surgical removal of each stent required a mean of 1.5 interventions and a mean hospital stay of 4.4 days.
  
  
  CONCLUSIONS
  At experienced centers combined endourological techniques can achieve successful and safe management of forgotten stents even in the pediatric age group. Thus, routine preprocedural tomography is a must in children with forgotten ureteral stents.
authors.affiliation: Department of Urology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey. aasancaktutar@gmail.com
authors.forename: Ahmet Ali
authors.initials: AA
authors.lastname: Sancaktutar
authors.forename: Şenol
authors.initials: Ş
authors.lastname: Adanur
authors.forename: Berkan
authors.initials: B
authors.lastname: Reşorlu
authors.forename: Abdülkadir
authors.initials: A
authors.lastname: Tepeler
authors.forename: Tevfik
authors.initials: T
authors.lastname: Ziypak
authors.forename: Haluk
authors.initials: H
authors.lastname: Söylemez
authors.forename: Murat
authors.initials: M
authors.lastname: Atar
authors.forename: Yaşar
authors.initials: Y
authors.lastname: Bozkurt
authors.forename: Necmettin
authors.initials: N
authors.lastname: Penbegül
authors.forename: Adnan
authors.initials: A
authors.lastname: Tüfek
authors.forename: Sevgi
authors.initials: S
authors.lastname: Yavuz
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D020878:Device Removal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005549:Foreign-Body Reaction / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D014513:Ureter / Q000000981:diagnostic imaging / Q000601:surgery*; D014514:Ureteral Calculi / Q000601:surgery*; D018666:Ureteroscopy / Q000379:methods*