Category: New Technology: Miscellaneous
Introduction & Objective :
Ureteric stents are an indispensable tool in the urologist armamentarium, Ttheir use may be limited because related to complications secondary to a prolonged stay and, in some cases, to a forgotten stent. Different methods have been proposed to reduce the rate of forgetfulness of these devices. In this study, we describe our experience with forgotten ureteric stents and discuss reported methods to avoid its occurrence.
1810 patients had a ureteric stent inserted between 2012 and 2016 at our institution. Twenty cases of forgotten ureteric stents were found tracked (1.1%). The indications for initial stent placement, duration of stent in the urinary system, presenting complaints, laboratory and radiographic findings and management of the forgotten stent removal weare reportedevaluated. Published reports on attempts to create ways to avoid forgotten ureteric stents were reviewed and are discussed.
The mean stent length of stay of DJ catheter was 12.95 months (range: 65-94) The most common presentation symptoms were renal colic (5 patients, 25%), hematuria (3 patients, 15%) and urinary sepsis (3 patients, 15%). The responsibility for the forgotten stent was attributed to the attending physician in 55% (11) of cases; in 35% (7 patients), it was attributed to the patient and in 10% (2 patients), it could not be defined. Encrustation of the stent was found in all cases: 8 cases on the proximal end (40%), 5 cases on distal end (25%), 4 cases on proximal and distal ends (20%), 2 cases on the entire catheter (10%), and 1 case just on the middle portion of the catheter (5%). There was no correlation between the length of stent stay and the calculus encrustation diameter using Fisher test (p = 0,367 CI: 95%). There was no correlation between the length of stent stay and presentation symptoms (p= 0,509)., Tthe FECAL classification system was concordant with our series in only 5 patients (25%). From patient-information booklets to eletronic stent register, many options were suggested to avoid this potentially life-threatening condition with poor results.
Conclusions : Based on the high proportion of forgotten ureteric stents withdrawal cases related to the medical team, a closer follow up of the medical team to the patient and the creation and implementation of withdrawal protocols are warranted. However, more consistent methods of ureteric stents tracking may be necessary.
Ana Cardenas-Ortiz– Urologist, Universidad del Rosario, Colombia, Bogota , Distrito Capital de Bogota, Colombia
Luiz Araujo– Sao Paulo, Sao Paulo, Brazil
Hamilto Yamamoto– Botucatu, Sao Paulo, Brazil
Paulo Kawano– Botucatu, Sao Paulo, Brazil
Rodrigo Guerra– Botucatu, Sao Paulo, Brazil
Joao Amaro– Botucatu, Sao Paulo, Brazil
Marcos Nogueira– Sao Paulo, Sao Paulo, Brazil
Horacio Consolmagno– Sao Paulo, Sao Paulo, Brazil
Americo Sakai– Sao Paulo, Sao Paulo, Brazil
Oscar Fugita– Universidade Estadual Paulista, Sao Paulo, Sao Paulo, Brazil
Universidad del Rosario, Colombia
Bogota , Distrito Capital de Bogota, Colombia
Urologist from Universidad del Rosario Bogotá colombia
Endourology fellowship from American urologic associaton , Hospital Estadial paulista Sao Paulo Brasil
Member of Endourological Society
Member of Colombian Society of Endourology
Specialist on Universitary teaching from Universidad del Bosque, Bogota Colombia