Retrospective review of retained double J stents: A single centre study

Abstract

Introduction: Retained Double J stents are associated with significant morbidity and mortality, if not intervened timely. So in the present study, consequences, management and their potential complications of forgotten/ retained DJ stents were analysed. Material and Methods: The records of patients presented to the department of urology, Nizam’s Institute Of Medical Sciences-Hyderabad with forgotten or long term retention of DJ stents from October 2013 to June 2019 were retrospectively analysed. All cases were reviewed for age, gender, indication for insertion of DJ stent, duration of stent insertion, radiological images and surgical procedures performed. Results: Total 78 patients reported to our department with history of forgotten DJ stents during six years period. Total 78 patient’s records were analysed over the period from October 2013 to June 2019. Out of which 49 (63%) were male and 29 (37%) were females. Age ranged from 7 years to 71 years (Mean 43.5±10 years). Duration with stent in situ ranged from 1 year to 9 years (Mean 3.5 ± 1.06 years). Presenting complaints of feverin 11%, haematuria in11% irritative LUTS in 39% and pain in 39% amongst patients were noted. Out of 78 patients, 10 (13%) patient had CLT, 13 (17%) patients had PCNL, 5 (6%) patients underwent URSL, 2 (3%) underwent nephrectomy and 43 (55%) underwent combined procedures. Combined procedures included CLT and URSL in 9(21%), PCNL and CLT in 12 (28%), PCNL and URSL in 9 (21%), PCNL and URSL and CLT in 13 (30%). 64% of patients had preoperative urine C/S positive. Majority of microorganisms were found E.coli. Treated with preoperative antibiotics. The majority of patients had fever postoperatively. 5 patients had septic shock, andmanaged conservatively. No mortality. Conclusion: Forgotten or retained stent is a source of severe morbidity. DJ stents should be used judiciously. Patient education and awareness plays a vital role in preventing retained stents.