Combined endoscopic surgery in the prone-split leg position for successful single-session removal of an encrusted ureteral stent: a case report
نویسندگان
چکیده
INTRODUCTION Although encrusted stents may lead to some unwanted complications including urinary tract obstruction, urinary sepsis, and potential loss of kidney function, there is currently no consensus on the most efficient method for managing stents that are intentionally left in situ. This is the first report describing the management of an encrusted stent using combined endoscopic surgery in the prone split-leg position in a single session. CASE PRESENTATION A 47-year-old Asian man presented with left flank pain and macrohematuria. The patient had undergone left ureteral stenting three years previously for the treatment of left ureteral stones and hydronephrosis; however, he was lost to follow-up before the treatment for the ureter stones was completed. Therefore, the ureteral stent and stones were not removed. An abdominal radiograph and a noncontrast computed tomography scan showed encrustation along the retained stent with stone burdens in the kidney and ureter. The ureteral stent could not be removed by cystoscopy after shock wave lithotripsy of the left ureteral stones. Therefore, endoscopic lithotripsy combined with flexible ureteroscopy and miniature nephroscopy was performed with the patient in the prone split-leg position. All the stones and the encrusted ureteral stent were successfully removed in a single session. CONCLUSIONS In this case, percutaneous nephrolithomy in addition to flexible ureteroscopy was preferred because severe encrustation of the proximal stent and ureteral stones complicated the therapeutic strategy. Combined endoscopic techniques in the prone split-leg position can achieve successful and safe management of encrusted stents.
منابع مشابه
Combined Percutaneous and Transurethral Lithotripsy for Forgotten Ureteral Stents With Giant Encrustation
BACKGROUND Ureteral stents are widely used in many urologic practices. However, stents can cause significant complications including migration, fragmentation, and encrustation and it may possibly be forgotten. Successful management of a retained, encrusted stent requires combined endourological approaches. OBJECTIVES To present our experience with the approaches for treating forgotten uretera...
متن کاملEndourological management of forgotten encrusted ureteral stents.
PURPOSE To present our experience and discuss the various endourological approaches for treating forgotten encrusted ureteral stents associated with stone formation. MATERIALS AND METHODS From July 2006 to December 2008, 14 patients (11 men and 3 women) with encrusted ureteral stents were analyzed. The average indwelling time of the stent was 4.9 years (range 1 to 12). Plain-film radiography ...
متن کاملSubcapsular Splenic Urinoma and Splenorenal Fistula: A New Complication of Percutaneous Nephrolithotomy
Background: Splenic urinoma has not been previously reported as a complication of percutaneous nephrolithotomy (PNL). Case Presentation: A 46-year-old Caucasian male underwent PNL for two large left renal stones. Surgery was performed in prone split-leg position, with access obtained through combined fluoroscopic guidance and direct ureteroscopic observation of the targeted calix. The tract was...
متن کاملMultimodal stone therapy for two forgotten and encrusted ureteral stents: a case report
INTRODUCTION Ureteral stent placement is a common procedure in daily urologic practice. To manage the problems of forgotten stents for many years needs multimodal stone therapy. CASE PRESENTATION We present a case of a 26-years-old Caucasian, white woman with two forgotten encrusted ureteral stents for 48 months. Multimodal stone therapy including extracorporeal shock wave (SWL), percutaneous...
متن کاملManagement of encrusted ureteral stents impacted in upper tract.
OBJECTIVES To present our series of patients with ureteral stent encrustation and give indwelling times and management. Encrustation is one of the most serious complications of ureteral stents. METHODS A retrospective review was undertaken of all encrusted stents during a 4-year period. The inclusion criterion was a stent that required some form of intervention above the ureteral orifice to r...
متن کامل