Encrusted ureteral double J stents risk factors: A retrospective study

Abstract

Background: The consequences and potential complications of encrusted double J (DJ) stents can be devastating. This work retrospectively reviews a series of Yemeni patients with encrusted DJ stents and shares the experience of handling such a challenging subject. Materials and Methods: A retrospective study was carried out from January 2016 to February 2021 at the Urology center, 48 Model Hospital, and Al-Khamseen Hospital, Sana’a, Yemen. About 30 patients with encrusted DJ stents for more than six months treated with various urological procedures were included in this study. The demographic characteristics, duration and indication of DJ stent placement, and surgical intervention were gathered and analyzed. Univariate analysis was performed to determine risk factors of long-standing encrusted DJ stent. Result: The mean age of patients was 31± 12.4 years (range 5–69), including 20 (66.7%) males and 10 (33.3%) females. The mean duration of DJ stents was 31.8± 20.8 months (12–120 months). The most common cause of long-standing encrusted DJ stent was poor compliance in 15 (50%) patients, followed by ignorance of DJ stent in 11 (36.7%) patients, and inability to access the hospital in 4 (13.3%) patients. Extracorporeal shock wave lithotripsy (ESWL) was the most common intervention performed in 11 (36.7%) patients as a single procedure. Multiple sessions of ESWL with another endourological procedure were required in 10 (33.3%) patients. A nephrectomy was performed on one (3.3%) patient due to a nonfunctional kidney. In univariate analysis, a longer duration of DJ stenting was associated with the need for multiple treatment modalities (p= 0.001). Factors such as poor compliance and farming community were associated with encrusted DJ stents in the female gender (p <0.05). In the male gender, ignorance of DJ stents was associated with encrusted DJ stents (p <0.05). Conclusion: A longer duration of DJ stenting is associated with worse outcomes, including DJ encrustation and the need for invasive and multiple treatment modalities. Poor compliance, residing in farming communities, and ignorance of the DJ stents are associated with long-standing encrusted risks and should be considered by the treating physicians.