FORGOTTEN JJ STENTS WITH STONES FORMATION, SPONTANEOUS FRAGMENTATION, MANAGEMENT AND OUTCOMES IN A CASE SERIES

Abstract

Objectives: The aim of this study was to explore the complications of forgotten JJ stents and management of its successful removal by avoiding further complications.

Methods: 9 patients who experienced complications due to forgotten stents. Over the period from January 2015 to December 2020, a total of 36 patients sought medical attention at our hospital for the same issue. Patients with having JJ stents in situ for more than 6 months were considered. Data was collected after hospital ethics committee approval. All the patients were followed for 3 months and assessed for stone clearance and other complications.

Results: Nine patients were presented with complications of whom 6 patients were male and 3 were female.  The mean age of the patients was 38.3 years. All the 9 patients needed PCNL for clearing the stones over the proximal coiled end of JJ stents. Two patients had retained pieces of broken stents, which were removed with semi rigid ureteroscope. Two patients needed Cystolitholapaxy for clearing the stone from the distal coiled end. Stones and fragmented pieces of stents were successfully cleared with no postoperative complications, the average hospital stay of the patients was 1.2 days.

Conclusion: In countries like Pakistan where resources are limited, mini PCNL is a good option to clear the stone and retrieve the stent or fragments of stents that are not accessible with semi rigid ureteroscope. Furthermore, it is crucial to provide comprehensive education and counseling to patients and maintain a stent register for reduction of such occurrence.