title: A simple two-stage "bailout" technique for the removal of an unyielding ureteric stent.
abstract: OBJECTIVE
  To describe a simple technique that can be used to manage an unexpected mildly to moderately (<10 mm) encrusted ureteric stent with consummate ease when time, equipment, or experience are unavailable.
  
  
  METHODS
  We present a series of 5 patients with impacted ureteric stents that were difficult to remove owing to presumed encrustation of the upper end. The indwelling time for the stent ranged from 8 to 16 weeks. All 5 patients were managed by insertion of a second ureteric stent alongside the original one.
  
  
  RESULTS
  The encrusted stents were successfully retrieved in all 5 patients at a subsequent visit after the insertion of the second stent, without the need for further specialist equipment or expertise.
  
  
  CONCLUSIONS
  Insertion of a second stent next to an unyielding, encrusted ureteric stent is a safe, simple, and effective technique to aid in its retrieval. We propose that it should be considered in select patients where encrustation is unexpected and an experienced endourologist is unavailable.
authors.affiliation: Department of Urology, Whittington Hospital National Health Service Trust, London, UK.
authors.forename: Kiki
authors.initials: K
authors.lastname: Mistry
authors.forename: Pallavi
authors.initials: P
authors.lastname: Pal
authors.forename: Sudhanshu
authors.initials: S
authors.lastname: Chitale
mesh_terms: D000328:Adult; D000368:Aged; D020878:Device Removal / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D015607:Stents / Q000009:adverse effects; D014513:Ureter / Q000000981:diagnostic imaging