Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2020; 8(23): 6043-6047
Published online Dec 6, 2020. doi: 10.12998/wjcc.v8.i23.6043
Huge encrusted ureteral stent forgotten for over 25 years: A case report
Dong Soo Kim, Sang Hyub Lee
Dong Soo Kim, Sang Hyub Lee, Department of Urology, School of Medicine, Kyung Hee University, Seoul 02447, South Korea
Author contributions: Kim DS and Lee SH contributed equally to this work; Lee SH designed the research study; Kim DS performed the research; Kim DS and Lee SH wrote the manuscript; all authors have read and approve the final manuscript.
Supported by Kyung Hee University in 2018; No. KHU-20182183.
Informed consent statement: This study was approved and reviewed by our Institutional Review Board.
Conflict-of-interest statement: The authors have no potential conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sang Hyub Lee, MD, PhD, Associate Professor, Department of Urology, School of Medicine, Kyung Hee University, Kyung Hee University Medical Center 23, Kyung Hee Dae-ro, Dongdaemun-gu, Seoul 02447, South Korea. uroshlee@khu.ac.kr
Received: June 30, 2020
Peer-review started: June 30, 2020
First decision: September 29, 2020
Revised: October 19, 2020
Accepted: November 2, 2020
Article in press: November 2, 2020
Published online: December 6, 2020
Processing time: 157 Days and 1.2 Hours
Abstract
BACKGROUND

Ureteral stent insertion is a relatively non-invasive procedure commonly used in the field of urology to resolve urinary obstruction. However, they are sometimes forgotten and the risk of complications increases with time.

CASE SUMMARY

A 43-year-old woman with a history of recurrent urinary tract infections visited our hospital for evaluation of persistent left flank pain, and lower urinary tract symptoms despite anti-biotic treatment. She had received urological surgery in her teens but did not know the details of her surgery. Kidney, ureter, and bladder X-ray and abdominopelvic computed tomography revealed a forgotten left ureteral stent with huge encrustation at both ends and a severely dilated left kidney with parenchymal thinning. In order to remove the ureteral stent, a laparoscopic nephroureterectomy was planned. The ureteral stent was successfully removed, and she was discharged after recovery. The patient was followed up for two years after surgery and did not show any signs of long-term complications.

CONCLUSION

Long indwelling stents can cause dire complications requiring radical interventions. Stent registry systems, novel stent material development, and proper patient education is important for complication prevention.

Keywords: Ureter; Stent; Calcification; Endoscopy; Nephroureterectomy; Complications; Case report

Core Tip: Ureteral stents are commonly used in urology and with appropriate care, it is considered a safe and easy procedure to manage ureter obstruction. However, due to multiple factors, its removal may be delayed which can result in stent calcification and infection. Even longer prolongation can lead to renal function decrease and parenchymal thinning from long-term obstruction which may require invasive procedures such as nephroureterectomy. Research on new stent material and specialized medical recordings dedicated to tracking stented patients are a few of the many ways that have been devised to prevent complications. Most importantly, thorough medical follow ups and detailed patient education is necessary in all cases to ensure the patients’ safety.