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Large renal stone with ureteral stone caused by 15 years of forgotten stent

  • Adnan Malahela ,
  • Octoveryal Aslim ,
  • Andhika Novianda ,
  • Widi Atmoko ,
  • Ponco Birowo ,
  • Nur Rasyid ,

Abstract

Introduction: Ureteral stents are commonly placed in urologic surgeries, and are especially indispensable in endourologic surgeries. But if it remains for more than 6 months, the probability of migration and calculus formation of the stent increases substantially.

Case description: A 57-year-old female came to the urology outpatient clinic due to left flank pain. She had a history of open left nephrolithotomy 15 years ago and had ureteral stent placed. She also had a history of open vesicolithotomy surgery 4 years ago and was told to have a follow-up surgery for the remaining kidney stone but she didn’t come because of the limited level of local medical services and her pain tolerance. NCCT study showed moderate left hydronephrosis with a high volume renal stone measuring 60x35x20 mm (HU 1.021), two proximal ureteral stones measuring 40x10x10 mm (HU 1.021) and 60x5x5 mm (HU 1.021) with ureteral stent shadow in the center. She had elevated urea nitrogen and creatinine levels, microscopic hematuria, leukocyturia, and positive urine bacteria. The patient underwent percutaneous nephrolithotomy (PCNL) with endoscopic combined intra-renal surgery (ECIRS) for stone removal. Postoperative recovery was successful with no residual stones and significant pain relief.

Conclusion: The case underscores the need for patient compliance, adequate practitioner counseling, and timely medical attention. The prevention of complications is the best treatment, and multimodal endourologic approaches can safely remove forgotten, encrusted double J stents.

Section

References

  1. De Grazia A, Somani BK, Soria F, Carugo D, Mosayyebi A. Latest advancements in ureteral stent technology. Transl Androl Urol. 2019;8(Suppl 4):S436–41. Available from: https://pubmed.ncbi.nlm.nih.gov/31656749
  2. Polat H, Yücel MÖ, Utangaç MM, Benlioğlu C, Gök A, Çift A, et al. Management of Forgotten Ureteral Stents: Relationship Between Indwelling Time and Required Treatment Approaches. Balkan Med J. 2017/04/06. 2017;34(4):301–7. Available from: https://pubmed.ncbi.nlm.nih.gov/28443570
  3. Adanur S, Ozkaya F. Challenges in treatment and diagnosis of forgotten/encrusted double-J ureteral stents: the largest single-center experience. Ren Fail. 2016;38(6):920–6. Available from: http://dx.doi.org/10.3109/0886022x.2016.1172928
  4. Ray RP, Mahapatra RS, Mondal PP, Pal DK. Long-term complications of JJ stent and its management: A 5 years review. Urol Ann. 2015;7(1):41–5. Available from: https://pubmed.ncbi.nlm.nih.gov/25657542
  5. Bultitude MF, Tiptaft RC, Glass JM, Dasgupta P. Management of encrusted ureteral stents impacted in upper tract. Urology. 2003;62(4):622–6. Available from: http://dx.doi.org/10.1016/s0090-4295(03)00506-5
  6. Beiko DT, Knudsen BE, Denstedt JD. Advances in Ureteral Stent Design. J Endourol. 2003;17(4):195–9. Available from: http://dx.doi.org/10.1089/089277903765444294
  7. Ringel A, Richter S, Shalev M, Nissenkorn I. Late Complications of Ureteral Stents. Eur Urol. 2000;38(1):41–4. Available from: http://dx.doi.org/10.1159/000020250
  8. Vajpeyi V, Chipde S, Khan FA, Parashar S. Forgotten double-J stent: Experience of a tertiary care center. Urol Ann. 2020/04/14. 2020;12(2):138–43. Available from: https://pubmed.ncbi.nlm.nih.gov/32565651
  9. Saha PK, Hossain MS, Ghosh KC, Alam MS, Nabi S, Saha BK, et al. Forgotten, encrusted ureteral stents: a challenging problem with an endourologic solution. Mymensingh Med J. 2018;27(1):149-158. Available from: https://pubmed.ncbi.nlm.nih.gov/29459607/
  10. Singh I, Gupta NP, Hemal AK, Aron M, Seth A, Dogra PN. Severely encrusted polyurethane ureteral stents: management and analysis of potential risk factors. Urology. 2001;58(4):526–31. Available from: http://dx.doi.org/10.1016/s0090-4295(01)01317-6

How to Cite

Malahela, A., Aslim, O. ., Novianda, A. ., Atmoko, W. ., Birowo, P. ., & Rasyid, N. . (2024). Large renal stone with ureteral stone caused by 15 years of forgotten stent. Indonesia Journal of Biomedical Science, 18(1), 87–89. https://doi.org/10.15562/ijbs.v18i1.551

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