A REPEAT X-RAY KUB: A NECESSARY THING AFTER ALL STONE SURGERIES IF THE INTENSITY OF PAIN INCREASE

Routinely after all endourological stone surgeries; a X-ray KUB is taken to ensure -stone clearance is complete or not and whether DJ stent if kept is in situ or not. We did a PCNL ; during the surgery there was a complete clearance on fluoroscopy and endoscopy.We kept a 5 Fr DJ stent in situ after the stone clearance. After the surgery on 1 st POD we usually take Xray KUB to confirm the stone clearance before we remove the nephrostomy. After the nephrostomy removal ; he was planned for discharge ( on 2 nd POD)then suddenly he started getting pain needing parenteral painkillers.Usually there is a tendency to attribute it to the presence of the stent( or urine reflux because of the stent) and discharge the patient.We repeated the X-ray and there was down migration of the stent and its upper end was lying in the lower ureter.

The patient was again taken up for stent reposition under sedation.

Pearl of wisdom:
Any increase in the pain disproportionate to the usual post-operative pain necessitates X-ray KUB to detect down-migated stents and treat them duly.