Lost in the shadows: shedding light on forgotten ureteral stent syndrome

Abstract

Abstract Ureteral stents have been essential in urology for over four decades, yet the challenge of retained or forgotten stents persists. This syndrome occurs when a DJ stent remains beyond its recommended removal time, typically more than 2 weeks, leading to complications like migration, fragmentation, and encrustation. We present a case of a 50-year-old woman with a two-month history of right flank pain, burning urination, and intermittent fever. She had undergone right stent lithotripsy 3 years prior. Imaging revealed a fractured double J stent with significant renal and bladder stones, extensive ureteral encrustation, and a large retroperitoneal collection. The right kidney showed cortical thinning and gross hydronephrosis. Initial management included broad-spectrum antibiotics, a pigtail catheter, and percutaneous nephrostomy. In a second session, mechanical cystolithotripsy and percutaneous nephrolithotomy removed the bladder and renal calculi, and the fractured stent ends. The patient recovered uneventfully. Forgotten ureteral stents often require staged endoscopic interventions due to encrustation. Timely stent removal is critical and often overlooked due to inadequate counseling. Establishing a stent registry and an automated reminder system via a mobile app could help prevent these occurrences.