forgotten dj stent– a source of morbidity: is stent registry a need of the hour?

Research Article
Patil S M, Magdum P V, Shete J S, Nerli R B* and Hiremath M B
DOI: 
xxx-xxxx-xxx
Subject: 
Medical
KeyWords: 
Forgotten DJ stent, Stent registry, Morbidity.
Abstract: 

Introduction

DJ Stents are placed in the ureter after open/endoscopic surgery or prior to ESWL in order to maintain the patency of the ureter and promote healing. Short term complications of DJ stents include infection, hematuria, pain and stent syndrome. However, long term retention of stents can lead to encrustations, stone formation, fractures and blockades of stents, hydronephrosis and at times loss of renal function. We report our experience in the management of forgotten stents and role of stent registry in preventing DJ stent related morbidity.

Materials and Methods

We retrospectively analysed the records of patients presented to the department of urology with forgotten or long term retention of DJ stents from January 2011 to January 2013. We recorded the duration of DJ stent, presenting complaints, type of previous procedure and procedure performed for removal of DJ stent & associated complication. And we prospectively analysed the feasibility and utility of stent registry from January 2013 to January 2014.

Results

During a two year study period, total 33 patients reported or were referred to our department with history of forgotten DJ stents. 14 patients had severe encrustations with both renal and vesical calculus. 8 others had either only renal or vesical calculus. 9 patients had fracture stents and vanishing portions of stents and 2 had multiple renal, ureteric and vesical calculi. A combination of PCNL, ureteroscopy, ESWL and open surgeries were done to clear the stones and extract the DJ stent. Stent registry showed marked decrease in rates of forgotten DJ stents.

Conclusions

Forgotten or retained stent is a source of severe morbidity and also financial strain. Pre operative and post operative counseling of the patient regarding the DJ stent is necessary. Maintaining stent registry is simple and feasible to avoid the morbidity associated with it.