On Yıldan Uzun Süre Üreteral J Stentle Yaşamanın Sonuçları

Year 2020, Volume: 15 Issue: 2, 59 - 65, 12.06.2020

Ekrem Akdeniz , Kenan Öztorun

https://doi.org/10.33719/yud.517004

Abstract

Amaç: Unutulmuş üreteral stentlerin infeksiyon, enkrustasyon, taşlaşma ve böbrek yetmezliği gibi majör komplikasyonları vardır. Bu komplikasyonlar stentin kalış süresi ile artar. Bu çalışmada 10 yıldan uzun süre üreteral stentle yaşayan hastaların tedavi yönetimi ve stentlerin hastalara verdiği zararlar tartışılmıştır.

Gereç Yöntem: 10 yıldan uzun süredir enkruste üreteral stentle yaşayan üç hastanın klinik verileri retrospektif olarak değerlendirildi.

Bulgular: Her üç hastada tipik stent semptomları (hematüri, yan ağrısı, acil idrar hissi, vs) olmadığı için doktora başvurmadıklarını belirtti. İki hasta sepsis ile bir hasta komplike üriner sistem enfeksiyonu ile tarafımıza başvurdu. Uzun süreli stente bağlı olarak 2 hasta ileri derecede böbrek fonksiyon kaybı gelişirken, 1 hasta böbreğini kaybetti. Nonfonksiyonel böbrekli hastaya laparoskopik nefroüreterektomi yapılırken, diğer iki hastaya tek seans multi-modal nefron koruyucu cerrahi uygulandı.

Sonuç: Teknolojideki gelişmelere rağmen unutulan stentler sepsise ve böbrek fonksiyon kaybına neden olmaya devam etmektedir. Enkruste stente bağlı komplikasyonlardan korunmanın  en güzel yolunun unutmamak olduğunu düşünüyoruz.

Keywords

Double-J stent , Enkrustasyon , Tedavi

Results of Living With an Encrusted Double J Stent for More Than 10 Years

Abstract

Objectives: Forgotten ureteral stents (FUS) may entail major
complications such as infection, migration, encrustation, stone formation, and
kidney failure. These complications increase with duration of stent indwelling.
We discuss our experience of therapeutic approaches to treatment management of
patients living with double J (DJ) stents for more than 10 years.

Materials and Methods: Data for three patients living encrusted DJ stents
for more than 10 years were evaluated retrospectively.

Results:
All three subjects stated that they did not present to physicians due to
absence of typical stent symptoms (such as hematuria, flank pain, and urgency).
All three patients presented to us with urinary tract symptoms. Advanced renal
function loss was present in two patients, and non-functional kidney in one.
Laparoscopic nephroureterectomy was performed on the patient with a
non-functional kidney, and multimodal nephron-sparing surgery on the other two.   

Conclusions: Despite all the many advances in technology,
long-term encrusted stents lead to sepsis and loss of kidney function. We think
that not forgetting is the best means of protection against encrusted
stent-related complications.

Keywords

Double-J stent , Encrustation , Forgotten , Treatment

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