Forgotten Ureteral Double-J Stents bilaterally complicated by hematuria скачать в хорошем качестве

Forgotten Ureteral Double-J Stents bilaterally complicated by hematuria

A double-J stent is never without potential complications which may be minor in form of hematuria, dysuria, frequency, flank and suprapubic pain to major complications such as vesicoureteric reflux, migration, malposition, encrustation, stent fracture etc. The indications include the relief of ureteral obstruction secondary to diverse etiologies, accommodating adequate postoperative drainage, and preventing ureteral injuries during surgical procedures. Mild transitory complications may be present even in a classical short-term use. The typical ‘stent syndrome’ may associate flank pain, frequency, urgency, suprapubic discomfort or pain, and sometime hematuria or incontinence. It is transitory but may cause high morbidity. Alpha-blockers have been used with good results for treating these temporary symptoms. Most serious long-term complications are associated with prolonged (superior to 6 months) indwelling times [1]. Infection, breakage, malposition or migration of the stent, and stone encrustations were reported. To prevent these events, stents require monitoring while they are in place, removal at the earliest appropriate time, and periodic exchange when chronically indwelling. Risk factors for complications should be minimized with high fluid intake, timely evaluation of clinical complaints, and aggressive treatment of documented infection. Abdominal plain films and ultrasonography are the most common imaging methods for the follow-up, even though our patient underwent CT first because colonic diverticulitis was suspected. Forgotten or overlooked stents – particularly in poor compliant patients – may sometimes irreversibly compromise the renal function.