A Pandemic of Retained Forgotten Stents
Prasanna Ram1*, Vasudevan T2 and Joseph Philipraj3
1MCh Urology, All India Institute of Medical Sciences, Sijua, Patrapada, Bhubaneswar, Odisha 751019
2Associate Professor, Department of Urology, Mahatma Gandhi Medical College and Research Institute, Puducherry 607402
3Head of the department, Department of Urology, Mahatma Gandhi Medical College and Research Institute, Puducherry 607402
Purpose: To review the management of a forgotten/ retained double J stent and attempt to suggest protocols to prevent this scenario.
Materials & methods: We included 12 patients with forgotten DJ stents who had their primary surgery done at our hospital between September 2019 and March 2021 and were unable to follow up due to the lockdown imposed for the COVID19 pandemic.
Results: Twelve patients underwent their forgotten DJ stent removal by a combination of ESWL, cystolithotripsy, and percutaneous nephrolithotomy. All the patients achieved complete clearance of the encrustations/stone and removal of forgotten DJ stent in a single sitting.
Conclusion: A forgotten DJ stent with encrustations and stone formation is a serious urological problem for the patient and the treating doctor. A stent is usually said to be forgotten if the indwelling time period is more than 3-6 months which was not intended by the treating doctor. In our series, the management and intervention depended on the patients' preop status, the severity of the encrustations, location, and the size of the stone. In patients with moderate-to-severe encrustations and stone presence, procedures such as CLT, ureteroscopy, and PCNL were performed.
Forgotten/retained stents are a source of severe morbidity and additional/unnecessary hospitalization. In our series, we suggested a few protocols that could be followed in order to prevent a forgotten DJ stent.