Ces Urol 2012, 16(2):101-107 | DOI: 10.48095/cccu2012013

Possibilities of endoscopic management of retained incrusted ureteral stents

Petra Kočovská¹, Viktor Eret¹, Pavla Toufarová¹, Zdeněk Chudáček², Milan Hora¹

¹ Urologická klinika LF UK a FN, Plzeň

² Radiodiagnostické oddělení LF UK a FN, Plzeň

Aim:
On long-term kept ureteral stents are formed incrustations, which gradually become bigger and present a complicated situation even for an experienced endourologist. The aim of this article is to demonstrate our experience with endoscopic solutions of this problem.
Material and method:
Since 1/2010 to 2/2012 there have been 10 cases of incrustant stents solved with 6 patients, 4 women and 2 men, at the Department of Urology at University Hospital in Pilsen. In 4 cases the stent was inserted due to secondary megaureter, in 3 cases due to ureterolithiasis and in 3 cases due to hydronephrosis. The average time of keeping the stent was 16.7 months (between 7 and 33 months). All patients forgot about the inserted stent. For the diagnosis we used intravenous urography in two cases, computer tomography in 5 cases, plain abdominal X-ray in 1 case and ultrasonography in 2 cases.

Results:
In all 10 cases the incrustations were present on the distal end of the stent, in 6 cases also a proximal end was incrusted and in 2 cases the whole stent, including the middle part, was incrusted. In 7 cases we used a combined endoscopic approach as a solution. All 6 patients are currently without lithiasis, two of them have permanently inserted stents due to secondary megaureters bilaterally. Analysis of the incrutstations proved that it was a mixed lithiasis. In 7 cases predominated apatite, in 3 cases struvite.

Conclusion:
Although patients sometimes forget about inserted stents, on which incrustation is formed after recommended time of keeping, it is possible to solve their problem with a quite high percentage of success.

Keywords: endoscopy, incrustation, stent

Received: March 14, 2012; Accepted: April 27, 2012; Published: March 1, 2012