Double J Stent an Indispensable Device in Modern Urology Practice-Timely Removal Prevents Catastrophic Complications: A Retrospective Observational Study

Abstract

Introduction: Double J (DJ) stent placement is routinely used for various urological procedures. The potential complications of retained or forgotten stents include haematuria, infection, pain, ureteral injury, displacement, fragmentation, encrustation, stone formation, sepsis, renal failure, or even mortality. Various methods have been used alone or in combination for the retrieval of these encrusted stents. Their timely removal is crucial as the potential complications of retained or forgotten stents are very catastrophic and not cost-effective. Aim: To highlight the importance of timely removal/replacement of DJ stents. Materials and Methods: A retrospective observational study was conducted in the Department of Urology at Government Medical College, Patiala, Punjab, India, and data were collected from March 2021 to March 2023. A total of 149 patients who underwent DJ stenting for various procedures in the department or were referred from outside with attempted difficult removal were included in the study. Relevant investigations were performed. Data were collected from the registers maintained in the operation theatre. Data are presented as mean, numbers, and proportions as appropriate. Various procedures were used alone or in combination for stent removal. Results: The mean age of the study participants was 41.50 years with a range from 16 to 70 years. A total of 149 patients were included, and 163 procedures were performed to remove the DJ stents. A total of 24 (14.81%) stents patients developed complications in the form of mild encrustation of the renal and urinary bladder end of the stent, up migration, down migration, broken stents, heavy encrustations at both renal and bladder ends, partial intraperitoneal placement and stone formation at renal and bladder ends. Out of 163 total procedures,149 (91.41%) endoscopic retrievals were done, and 14 (8.59%) multiple procedures were done to remove stent fragments and stones. Postoperative complications were seen in 25 (16.78%) patients. Conclusion: Timely removal of DJ stents prevents catastrophic complications. The phrase by Desiderius Erasmus, “Prevention is better than cure,” holds merit in the present study.

Keywords

• cystoscopy
• encrustations
• forgotten stents
• lithotripsy
• ureterorenoscopy