Part of the Solution and Part of the Problem-Report on the Ureteric Stent Use in a Tertiary Referral Center in Australia

Abstract

Background: The aim of the study is to comprehensively report on a single tertiary referral centre experience with the use of ureteric stents, assess complication burden and determine risk factors to further inform institutional practice. Materials and methods: The retrospectively analysed cohorts include 529 patients treated over a 12 months period. Data regarding details of the index pathology, stent characteristics and complications were collected retrospectively. Results: Most stents (58.9%) were used in the context of stone surgery. Stent encrustation occurred in 14.5% of patients and sepsis in 4.3%. There was a statistically significant difference be-tween the complications of the stents removed after 90 days (76.3% of encrustations, 26.8% positive urine cultures) and the rest of the cohort. Overall, 7.6% of patients re-presented to the emergency department due to stent related complications (pain, haematuria, sepsis) and 2.4% required early stent removal. At our institution, we managed to avoid forgotten stents and catastrophic complications. Conclusions: Stent complications are the complex outcome of interplay between the foreign body and the collecting system environment, influenced by the nature and timing of surgery. Longer stent dwelling times are associated with increased complications rates. Planning definitive management and stent extraction needs to take into account the statistically significant differences between the subgroups with significant co-morbidities.