Factors Affecting Forgotten Ureteral Stents

Year 2025, Volume: 17 Issue: 3, 111 - 118, 30.09.2025

Çağrı Coşkun , Uğur Aydın , Kayhan Tarım , Engin Dereköylü

https://doi.org/10.54233/endourolbull-1701002

Abstract

Objective: Ureteral double-J (DJ) stents are frequently used in urology. Overdue or forgotten DJ stents are associated with many complications. This study will examine the factors affecting the stent forgetting period of patients with forgotten DJ stents.
Materials and Methods:
It was reviewed by Ağrı İbrahim Çeçen University Scientific Research Ethics Committee and approved with the decision numbered 108 dated 27.03.2025. Data from 12 patients with DJ stent indwelling longer than 6 months between January 2017 and December 2024 at Ağrı Training and Research Hospital, a rural tertiary center in Türkiye, were examined. Two groups were formed according to the median stent indwelling time: short-term (group 1) and long-term (group 2). The patient’s age, gender, DJ stent placement indication, additional endourological procedure need and duration, restenting rates, and distances to the hospital were compared.
Results: There was no difference between the two groups regarding gender, indication for stent placement, additional endourological procedures, and restenting rate after additional endourological procedures. The mean age was 43.5 years (SD: 11) in group 1 and 61.3 years (SD : 9.5) in group 2 (p: 0.012). Median additional endourological procedures’ duration was 37.5 minutes (IQR:27.5-40) in group 1 and 67.5 minutes (IQR: 52.5-87.5) in group 2 (p = 0.005). Median distance to the hospital was 38.5 kilometers (IQR: 19.25-77.75) in group 1 and 85.5 kilometers (IQR: 75.75-91.5) in group 2 (p = 0.037).
Conclusion: Our study concluded that patients whose DJ stents were forgotten for longer were older and resided in a center farther from the hospital. It would be beneficial to be careful, especially in this patient group.

Keywords

distance , encrustation , forgotten ureteral stent

Ethical Statement

This study was approved by the Ethics Committee of Ağrı İbrahim Çeçen University, on 2025/03/27 with approval number 108.

Supporting Institution

The authors have no relevant financial or non-financial interests to disclose.

Unutulmuş Üreteral Stentleri Etkileyen Faktörler

Abstract

Amaç: Üreteral double-j (DJ) stentler ürolojide sıklıkla kullanılır. Gecikmiş veya unutulmuş DJ stentler birçok komplikasyonla ilişkilidir. Bu çalışmada unutulmuş DJ stentli hastaların stent unutma süresini etkileyen faktörler incelenecektir.
Gereç ve Yöntemler: Ağrı İbrahim Çeçen Üniversitesi Bilimsel Araştırmalar Etik Kurulunca incelenmiş olup, 27.03.2025 tarih ve 108 sayılı karar ile onaylanmıştır. Türkiye’de perifer bir üçüncü basamak merkez olan Ağrı Eğitim ve Araştırma Hastanesi’nde Ocak 2017 ile Aralık 2024 arasında DJ stent kalma süresi 6 aydan uzun olan 12 hastanın verileri incelendi. Ortanca stent kalma süresine göre iki grup oluşturuldu: kısa süreli (grup 1) ve uzun süreli (grup 2). Hastaların yaşı, cinsiyeti, DJ stent yerleştirme endikasyonu, ek endoürolojik prosedür ihtiyacı ve süresi, tekrar stentleme oranları ve hastaneye olan mesafeleri karşılaştırıldı.
Bulgular: Cinsiyet, stent yerleştirme endikasyonu, ek endoürolojik prosedürler ve ek endoürolojik prosedürlerden sonra tekrar stentleme oranları açısından iki grup arasında fark yoktu. Grup 1’de ortalama yaş 43,5 yıl (SD: 11) ve grup 2’de 61,3 yıl (SD: 9,5) idi (p: 0,012). Ortanca ek endoürolojik prosedür süresi grup 1’de 37,5 dakika (IQR: 27,5-40) ve grup 2’de 67,5 dakika (IQR: 52,5-87,5) idi (p = 0,005). Hastaneye olan ortanca uzaklık grup 1’de 38,5 kilometre (IQR: 19,25-77,75) ve grup 2’de 85,5 kilometre (IQR: 75,75-91,5) idi (p = 0,037).
Sonuçlar: Çalışmamızda DJ stentleri daha uzun süre unutulan hastaların daha yaşlı olduğu ve hastaneye daha uzak bir merkezde ikamet ettiği sonucuna varılmıştır. Özellikle bu hasta grubunda dikkatli olmak faydalı olacaktır.

Keywords

enkrustasyon , unutulmuş üreteral stent , uzaklık

References

• 1. Borboroglu PG, Kane CJ. Current management of severely encrusted ureteral stents with a large associated stone burden. J Urol. 2000;164(3 Pt 1):648-50. https://doi.org/10.1016/S0022-5347(05)67257-5
• 2. Finney RP. Experience with new double J ureteral catheter stent. J Urol. 1978;120(6):678-81. https://doi. org/10.1016/S0022-5347(17)57673-7
• 3. Joshi H, Stainthorpe A, MacDonagh R, Keeley F, Timoney A. Indwelling ureteral stents: evaluation of symptoms, quality of life and utility. J Urol. 2003;169(3):1065-9. https://doi.org/10.1097/01.ju.0000048980.33849.6d
• 4. Monga M, Klein E, Castaneda-Zuniga WR, Thomas R. The forgotten indwelling ureteral stent: a urological dilemma. J Urol. 1995;153(6):1817-9. https://doi.org/10.1016/S0022-5347(01)67451-5
• 5. Slaton JW, Kropp KA. Proximal ureteral stent migration: an avoidable complication? J Urol. 1996;155(1):58-61. https://doi.org/10.1016/S0022-5347(01)66565-4
• 6. Persky L, Lockhart JJ, Karp R, Helal M, Hakki S. The overlooked, retained Double J stent. Urology. 1990;36(6):519-21. https://doi.org/10.1016/0090-4295(90)80079-M
• 7. Richter S, Ringel A, Shalev M, Nissenkorn I. The indwelling ureteric stent: a ‘friendly’ procedure with unfriendly high morbidity. BJU Int. 2000;85(4):408-11. https://doi.org/10.1046/j.1464-410x.2000.00460.x
• 8. Biyabani FR. Physician responsibility for removal of implants: the case for a computerized program for tracking overdue double-J stents. Tech Urol. 2000;6(3):189-92.
• 9. Divakaruni N, Palmer CJ, Tek P, Bjurlin MA, Gage MK, Robinson J, et al. Forgotten ureteral stents: who’s at risk? J Endourol. 2013;27(8):1051-4. https://doi.org/10.1089/end.2012.0604
• 10. El-Faqih S, Shamsuddin A, Chakrabarti A, Atassi R, Kardar A, Osman M, et al. Polyurethane internal ureteral stents in treatment of stone patients: morbidity related to indwelling times. J Urol. 1991;146(6):1487-91. https://doi. org/10.1016/S0022-5347(17)38298-7
• 11. Bultitude MF, Tiptaft RC, Glass JM, Dasgupta P. Management of encrusted ureteral stents impacted in upper tract. Urology. 2003;62(4):622-6. https://doi.org/10.1016/S0090-4295(03)00574-6
• 12. Singh V, Srinivastava A, Kapoor R, Kumar A. Can the complicated forgotten indwelling ureteric stents be lethal? Int Urol Nephrol. 2005;37:541-6. https://doi.org/10.1007/s11255-004-7505-5
• 13. Mohan-Pillai K, Keeley FX Jr, Moussa SA, Smith G, Tolley DA. Endourological management of severely encrusted ureteral stents. J Endourol. 1999;13(5):377-9. https://doi.org/10.1089/end.1999.13.377
• 14. Kawahara T, Ito H, Terao H, Yoshida M, Matsuzaki J. Ureteral stent encrustation, incrustation, and coloring: morbidity related to indwelling times. J Endourol. 2012;26(2):178-82. https://doi.org/10.1089/end.2011.0430
• 15. Tang VC, Gillooly J, Lee EW, Charig CR. Ureteric stent card register–a 5-year retrospective analysis. Ann R Coll Surg Engl. 2008;90(2):156-9. https://doi.org/10.1308/003588408X242058
• 16. Lynch MF, Ghani KR, Frost I, Anson KM. Preventing the forgotten ureteric stent: results from the implementation of an electronic stent register. BJU Int. 2007;99(2):245-6. https://doi.org/10.1111/j.1464-410X.2006.06641.x
• 17. Sancaktutar AA, Tepeler A, Söylemez H, Penbegül N, Atar M, Bozkurt Y, et al. A solution for medical and legal problems arising from forgotten ureteral stents: initial results from a reminder short message service (SMS). Urol Res. 2012;40(3):253-8. https://doi.org/10.1007/s00240-011-0413-9
• 18. Lynch MF, Ghani KR, Frost I, Anson KM. Preventing the forgotten ureteral stent: implementation of a web-based stent registry with automatic recall application. Urology. 2007;70(3):423-6. https://doi.org/10.1016/j.urology.2007.04.019
• 19. Molina WR, Pessoa R, Donalisio da Silva R, Kenny MC, Gustafson D, Nogueira L, et al. A new patient safety smartphone application for prevention of “forgotten” ureteral stents: results from a clinical pilot study in 194 patients. Patient Saf Surg. 2017;11:1. https://doi.org/10.1186/s13037-017-0140-1
• 20. McCahy P, Ramsden P. A computerized ureteric stent retrieval system. Br J Urol. 1996;77(1):147-8. https://doi. org/10.1046/j.1464-410X.1996.84913.x
• 21. Joshi H, Newns N, Stainthorpe A, MacDonagh R, Keeley Jr F, Timoney A. The development and validation of a patient‐information booklet on ureteric stents. BJU Int. 2001;88(4):329-34. https://doi.org/10.1046/j.1464- 410X.2001.02346.x
• 22. Eke T, Rom E, Castillo A. Patients with implants should be given implant cards: intraocular lens implant cards contain inadequate clinical data. BMJ. 1998;316(7139):1245. https://doi.org/10.1136/bmj.316.7139.1245