Abstract
We present a case of a 55-year-old male who presented three days after laser lithotripsy and insertion of a 6 CH multilength JJ stent. Symptoms included abdominal pain and visible haematuria. Investigations included a CT scan showing the stent to be in a satisfactory position with no encrustation. Unexpected difficulty was encountered on cystoscopic removal as the stent would not come out entirely. Abdominal X-ray showed the proximal end of the stent to be knotted and stuck at the vesicoureteric junction. He was transferred to the operating theatre, and the stent was successfully removed with continuous traction under a general anaesthetic. Post-removal cystoscopy and retrograde pyelogram showed an intact urinary tract with inflammation at the left ureteric orifice. Knotting of ureteric stents is a rare complication but has been reported previously in the literature. The exact aetiology is not known; however, it has previously been attributed to excessive length of stent within the renal pelvis. Several methods of removing a knotted stent have been reported, including traction, ureteroscopic untying, laser destruction of the stent, retrograde removal, and open surgery. Choice of technique will vary depending on anatomical location of the knot.
Published Version
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