A Urological Twist: Literature Review, An Australian Experience and Management Algorithm for Knotted Ureteric Stents

Abstract

Knotted ureteric stents remain a rare complication, with only 34 cases reported to date. They require prompt recognition and skilful management to avoid ureteric injury. Knots more often occur at the proximal end of stents, have a male preponderance, are associated with multi-length stents and relate to the J-coil configuration, which is affected by the renal pelvis anatomy, hydroureter and presence of urolithiasis. We present our experience of a knotted stent managed using holmium:yttrium aluminium garnet laser and traction. We also provide an updated literature review and recommend a treatment algorithm for this rare but important complication.

Keywords

• knotted ureteric stent
• holmium:yag laser
• stent removal
• multi-length stent
• percutaneous nephrostomy
• treatment algorithm