Thursday, June 30, 2011

Forgotten ureteric stent:Avoidable condition



In urology stents have a special place.In almost all cases pertaining to endourology; stent placement is usually assorted to.The stent less surgery is gaining momentum but majority of the urologist including the ones in our centre are very comfortable with stented surgery.The stents have its own complications like stent related pain,dysuria,UTI etc in the immediate post-operative period.But if the stent is kept inadvertently for longer period then stent encrustation,stone formation,stent fragmentation can alos occur.Most of the cases the forgotten stent is due to poor compliance.But still the treating urologist needs to be proactive in pursuing such cases.Stent registry is a good concept as it is practically impossible to follow up each and every patient without systematic dedicated registry services.



Forgotten stents are dealt on the merit of each case.The intervention can be open surgery,URS,PCNL,Cystolithotripsy superadded with the ESWL.With the advent of LASER; almost all the cases can be dealt with endourology.



A 47 year old patient came to us with prior history of stone disease treated with ESWL and stenting 4 years back.She was suffering from recurrent UTIs.She was investigated and we saw a forgotten stent with stone formation at the both ends.She is planned for LASER cystolithotripsy and LASER URS and stent retrieval from below after cutting it at the level of the pelvi-ureteric junction.Then followed by PCNL for the partial staghorn calculus formed at the upper end of the calculus.

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