title: Challenges in treatment and diagnosis of forgotten/encrusted double-J ureteral stents: the largest single-center experience.
abstract: OBJECTIVE
  We aimed to evaluate the effectiveness of the endourologic management of forgotten and/or encrusted ureteral stents together with our single-center experience.
  
  
  METHODS
  Fifty-four patients with forgotten double-J ureteral stents were treated in our center between January 2008 and March 2014. Encrustation and the related stone burdens were estimated by using computerized tomography and kidney-ureter-bladder radiography. The management method was chosen based on the stone burden or clinical and radiological findings.
  
  
  RESULTS
  Fifty-four patients, 39 males and 15 females, were included in the study. The average age of the patients was 38.2 ± 25.06 (2-86) years. The average indwelling time of the ureteral stents was 22.6 ± 30.3 (6-144) months. Six of the patients with forgotten stents had solitary kidneys. The double-J stent (DJS) was fragmented in four (7.4%) patients. A urinary system infection was present in 15 (27.7%) of the patients. The ureteral stents and related stones were successfully removed without any complications by combined endourologic techniques to achieve a stone-free state in all patients except for patient with 110 months of forgotten stent time in whom nephrectomy was performed for a nonfunctioning kidney related to the forgotten stent.
  
  
  CONCLUSIONS
  Forgotten/encrusted DJS may lead to complications in a range of urinary system infections, up to a loss of renal function. They can be safely and successfully removed, and the renal function can be preserved by endourologic techniques, starting with the least invasive procedures in centers highly experienced.
authors.affiliation: a Department of Urology, Faculty of Medicine , Ataturk University , Erzurum , Turkey.
authors.forename: Senol
authors.initials: S
authors.lastname: Adanur
authors.affiliation: a Department of Urology, Faculty of Medicine , Ataturk University , Erzurum , Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Ozkaya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D020878:Device Removal / Q000379:methods*; D005260:Female; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008318:Malpractice; D008875:Middle Aged; D011859:Radiography; D015607:Stents / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D014421:Turkey; D014463:Ultrasonography; D014513:Ureter / Q000601:surgery*; D014514:Ureteral Calculi / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult
keywords: Double-J stent; encrustation; endourology; forgotten; treatment