Dj Stenting: Retrospective Analysis of Indications and its Attached Complexity
Article Sidebar
Main Article Content
Abstract
Background: Ureteric stents are commonly used to manage nephro-ureterolithiasis and other ureteric obstructions, but their use is often associated with various complications. Understanding the indications for stenting and the frequency and nature of these complications is critical for improving patient outcomes.
Objective: To analyze the indications for and complications associated with double-pigtail ureteric stenting in a retrospective cohort.
Methods: This retrospective study involved 110 renal units in 90 patients who received double-pigtail ureteric stents from October 2022 to March 2024 to relieve ureteric obstruction. Stents were inserted both retrogradely via cystoscopy and antegradely through nephrostomy. The types of stents used were either polyurethane, intended for up to 3 months, or silicone, for longer durations. Follow-up included regular imaging to monitor stent position and complications, with data analysis performed using SPSS version 25.
Results: The primary indications for stenting included nephro-ureterolithiasis (88 patients), post-abdominopelvic surgery (11), prostate cancer (5), retroperitoneal fibrosis (4), and after irradiation (2). Complications were noted in 31% of patients, with bacteriuria and fever most common. Hydronephrosis was reported in 27 of these cases, with symptoms unchanged in 21, worsened in 3, and de novo in 3. Other complications included stent migration (8%), fragmentation (10%), and forgotten stents (4.5%). Stent removal was necessary in many cases due to severe complications.
Conclusion: Ureteric stents are effective for managing ureteric obstruction but are associated with significant risks, including infection, migration, and hydronephrosis. Careful patient monitoring and timely management of complications are essential to optimize outcomes.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Beysens M, Tailly TO. Ureteral Stents in Urolithiasis. Asian J Urol. 2018;5(4):274–286. Available from: https://doi.org/10.1016/j.ajur.2018.07.002
Scameciu I, Lupu S, Pricop C, Morbidity SC. Impact on Quality of Life in Patients with Indwelling Ureteral Stents: A 10-Year Clinical Experience. Pak J Med Sci. 2015;31(3):522–6. Available from: 10.12669/pjms.313.6759.
Mosayyebi A, Manes C, Carugo D, Somani BK. Advances in Ureteral Stent Design and Materials. Curr Urol Rep. 2018;19(5):35. Available from: https://doi.org/10.1007/s11934-018-0779-y
Brotherhood H, Lange D, Chew BH. Advances in Ureteral Stents. Transl Androl Urol. 2014;3(3):314–319.
Burns EJ, Smith PM, Liew M. Proximal Migration of a 'Double J' Ureteric Stent in a Patient with a Staghorn Calculus. J Surg Case Rep. 2020;(12). Available from: https://doi.org/10.1093/jscr/rjaa527
Xie D, Hu C, Gu D, Cai C, Liu Y, Zeng G, Lei M. Experiences in Managing Different Consequences of Forgotten Ureteral Stents. Urol Ann. 2022;14(2):141–146. Available from: https://doi.org/10.4103/UA.UA_165_20
Wang X, Ji Z, Yang P, et al. Forgotten Ureteral Stents: A Systematic Review of Literature. BMC Urol. 2024;24:52. Available from: https://doi.org/10.1186/s12894-024-01440-9
Pérez-Fentes D, Aranda-Pérez J, de la Cruz JE, Soria F. Indications, Complications and Side Effects of Ureteral Stents. In: Soria F, Rako D, de Graaf P, editors. Urinary Stents. Cham: Springer; 2022. Available from: https://doi.org/10.1007/978-3-031-04484-7_2
Corvino A, Basile L, Cocco G, Delli Pizzi A, Tafuri D, Corvino F, Catalano O. Complications Subsequent to Urinary Tract Stent Placement: An Overview Focusing on the Imaging of Cancer Patients. Medicina (Kaunas). 2024;60(2):338. Available from: https://doi.org/10.3390/medicina60020338
Braga LH, McGrath M, Farrokhyar F, Jegatheeswaran K, Lorenzo AJ. Society for Fetal Urology Classification vs Urinary Tract Dilation Grading System for Prognostication in Prenatal Hydronephrosis: A Time to Resolution Analysis. J Urol. 2018;199(6):1615-21.
Kulkarni R. Metallic Stents in the Management of Ureteric Strictures. Indian J Urol. 2014;30(1):65–72. Available from: https://doi.org/10.4103/0970-1591.124210
Shabeena KS, Bhargava R, Manzoor MAP, Mujeeburahiman M. Characteristics of Bacterial Colonization After Indwelling Double-J Ureteral Stents for Different Time Duration. Urol Ann. 2018;10(1):71–75. Available from: https://doi.org/10.4103/UA.UA_158_17
Paul CJ, Brooks NA, Ghareeb GM, Tracy CR. Pilot Study to Determine Optimal Stent Duration Following Ureteroscopy: Three versus Seven Days. Curr Urol. 2018;11(2):97–102. Available from: https://doi.org/10.1159/000447201
Geavlete P, Georgescu D, Mulțescu R, Stanescu F, Cozma C, Geavlete B. Ureteral Stent Complications - Experience on 50,000 Procedures. J Med Life. 2021;14(6):769–775. Available from: https://doi.org/10.25122/jml-2021-0352
Bellos TC, Katsimperis SN, Tzelves LI, Kostakopoulos NA, Markopoulos TP, Mitsogiannis IC, Varkarakis IM, Papatsoris AG, Deliveliotis C. Ureteral Stents: A Brief Narrative Review of the Different Polymeric Types, Their Characteristics, and Their Connection to Stent-Related Symptoms. Urol Ann. 2023;15(4):360–367. Available from: https://doi.org/10.4103/ua.ua_39_23
Hewitt IK, Montini G, Marks SD. Vesico-Ureteric Reflux in Children and Young People Undergoing Kidney Transplantation. Pediatr Nephrol. 2023;38(9):2987–2993. Available from: https://doi.org/10.1007/s00467-022-05761-5
Chua ME, Morales ML Jr. Spontaneous Fracture of Indwelling Polyurethane Ureteral Stents: A Case Series and Review of Literature. Can Urol Assoc J. 2012;6(5):386–392. Available from: https://doi.org/10.5489/cuaj.12013
El-Deen ME, Khalaf I, Rahim FA. Effect of Internal Ureteral Stenting of Normal Ureter on the Upper Urinary Tract: An Experimental Study. J Endourol. 1993;7:399–405.
Iranipour BJ, Rosander JH, Zetterberg M. Visual Improvement and Lowered Intraocular Pressure After Surgical Management of In-The-Bag Intraocular Lens Dislocation and Aphakia Correction; Retrospective Analysis of Scleral Suturing versus Retropupillary Fixated Iris-Claw Intraocular Lens During a 5-Year Period. Clinical Ophthalmology. 2024 Dec 31:315-24.
Godden L, Borgen R. Professionalizing the Canadian Career Development Sector: A Retrospective Analysis. Canadian Journal of Career Development. 2024 Jan 26;23(1):34-47.