English

Abstract

AIMS AND OBJECTIVES: To present our experience and discuss the various endourological approaches for treating forgotten encrusted (Retained) ureteral stents associated with stone formation. MATERIALS AND METHODS: From October 2011 to January 2014, 30 patients (18 men and 12 women) with encrusted ureteral stents were analyzed. The average indwelling time of the stent was 4.9 years (range 1 to 12). X-ray kidney urinary blader (KUB), Non contrast CT abdomen was used to evaluate encrustation, stone burden, and fragmentation of the stents. Intravenous urogram and a Tc99m diethylene triamine penta acetic-acid renogram was used to assess renal function. RESULTS: In eight patients, the entire stent was encrusted, in three patients the encrustation was confined to the ureteral and lower coil part of the stent, five patients had encrustation of the lower coil, one patient had upper coil and ureteral encrustation, four patients had only upper coil encrustation, five patients had both upper coil and lower coil encrustation and minimal encrustation was observed in four patients. Percutaneous nephrolithotomy was performed in 2 cases, combined percutaneous nephrolithotomy and retrograde ureteroscopy with intracorporeal lithotripsy in 1patient, combined cystolithotripsy and percutaneous nephrolithotomy in 5 patients, combined cystolithotripsy and ureteroscopic lithotripsy in 3 patients and combined cystolithotripsy, ureteroscopic lithotripsy and percutaneous nephrolithotomy in 6 patients. Only cystolithotripsy was used to manage the distal coil of the encrusted stent in 5 patients. Simple cystoscopic removal of the stents with minimal encrustation was carried-out in two cases. Only two patients required open surgical removal of the stent. 27 out of 30 patients were rendered stone and stent free in one session. 2 patients died before any intervention for removal of retained stents due to renal failure. One patient underwent nephrectomy for non-functioning kidney. CONCLUSION: Endourological management of forgotten encrusted stents is highly successful and often avoids the need for open surgical techniques.