CURRENT MANAGEMENT OF SEVERELY ENCRUSTED URETERAL STENTS WITH A LARGE ASSOCIATED STONE BURDEN

Abstract

We review our recent experience with encrusted retained ureteral stents associated with a large stone burden as well as current endoscopic options available for management. One man and 3 women presented to our department between May 1998 and April 1999 for treatment of an encrusted retained ureteral stent. One patient had a history of 3 episodes of ureteral stent encrustation during the last 6 years. We reviewed the management of these stents and the associated stone burden. Average patient age was 32.5 years (range 25 to 41). Average interval that the encrusted stent remained in place was 7 months (range 3 to 12). In the 3 women pregnancy was associated with the retained stent. All patients required 2 to 6 endourological approaches (average 4.2) performed at 1 or multiple sessions to render them stone-free and stent-free. Postoperatively sepsis in 1 case necessitated a prolonged intensive care unit stay with eventual recovery. Successful management of a retained encrusted stent requires combined endourological approaches. Percutaneous nephrostolithotomy and ureteroscopy are often necessary for treating a severely encrusted stent and the associated stone burden.