Reporting 5 Cases of Forgotten Ureteral Stent Treated by Endourological Approaches and Citrate Alkaline Therapy
Abstract
Purpose: This research it intended to present our experience in various endourological approaches and citrate alkaline therapy for treating forgotten encrusted ureteral stents.
Material and Methods: During the term starting from January 2010 till December 2013, five patients; 2 males and 3 females; with encrusted urethral stents, were studied. The average indwelling time of the stent was 5 years (range is 2 to 13 years). Mean ages were 37 years old. Kidney function test, urine culture, coronal computerized tomography (C/T) scan without contrast, plain- film radiography, intravenous urogram and renal isotopes scan were used for renal function assessment.
Results: The entire stent of all patients sample was encrusted. An Extracorporeal shock waves lithotripsy (ESWL) was performed for all, in addition to citrate alkaline medication in order to trying stopping the progress of encrustation and the growth of stones. Cystolithotripsy was used to manage the distal coil of the encrusted stents and in some cases we used cystolitholapaxy to crush bladder stones in addition to heavily encrusted stents. All patients rendered stone and stent free. One patient remained in the follow up symptomatic with loin pain, and thus he needed open surgery of nephrectomy due to impaired non-function kidney, with the histopathology report of malakoplakia of the kidney; which is rare inflammatory disease that is associated with Escherichia Coli infection.
Conclusion: Endourological management and alkaline medication of forgotten stents is highly successful and often there is no need for open surgery.
Material and Methods: During the term starting from January 2010 till December 2013, five patients; 2 males and 3 females; with encrusted urethral stents, were studied. The average indwelling time of the stent was 5 years (range is 2 to 13 years). Mean ages were 37 years old. Kidney function test, urine culture, coronal computerized tomography (C/T) scan without contrast, plain- film radiography, intravenous urogram and renal isotopes scan were used for renal function assessment.
Results: The entire stent of all patients sample was encrusted. An Extracorporeal shock waves lithotripsy (ESWL) was performed for all, in addition to citrate alkaline medication in order to trying stopping the progress of encrustation and the growth of stones. Cystolithotripsy was used to manage the distal coil of the encrusted stents and in some cases we used cystolitholapaxy to crush bladder stones in addition to heavily encrusted stents. All patients rendered stone and stent free. One patient remained in the follow up symptomatic with loin pain, and thus he needed open surgery of nephrectomy due to impaired non-function kidney, with the histopathology report of malakoplakia of the kidney; which is rare inflammatory disease that is associated with Escherichia Coli infection.
Conclusion: Endourological management and alkaline medication of forgotten stents is highly successful and often there is no need for open surgery.
