Original Articles
Forgotten DJ stents – difficult situation | |
Dr. Siddharth Dube, Dr. Shailendra Patel, Dr. Faiz Ahmed Khan | |
Background: DJ Stents are placed in the ureter after open/endoscopic surgery or prior to ESWL if renal calculi are large in size in order to maintain the patency of the ureter and promote healing. We report our experience in the management of forgotten stents and steps taken by us to preventing DJ stent related morbidity. Materials and methods: It is a prospective study conducted at Department of Urology, Sri Aurobindo Medical College and P.G. Institute, Indore, Madhya Pradesh, India, which is a tertiary care center over a period of 18 months. The total no of cases were 12. All the patients were evaluated with history, socioeconomic status and literacy. Patients underwent USG KUB, X ray KUB , urine analysis, serum creatinine. Non-contrast CT was done when indicated. Sterile urine was ensured before intervention. The plan of treatment was decided on the basis of investigations. Results: Out of 12 patients studied, 8 (66.67%) were men and 4(33.33%) were women. The average age of patient in the group was 56.67 years (range 45-66 years). The mean duration of stent in situ was 13.83 months (range 6months -15 years). 10(83.33%) patients had flank pain, 9 (75%) had with dysuria, 3(25%) patients had hematuria and (16.67%) had fever. Only 2 patients (out 12 patients) had higher secondary education and all hailed from rural India with poor socioeconomic background. Out of 12 patients 6 (50%) patients underwent URSL (uretescopic lithotripsy) 2 (16.67%) underwent PCNL (percutaneous nephrolithotomy) and 3(25%) underwent ESWL (extracorporal shock wave lithotripsy) 3(25%) underwent CLT, 1(8.33%) required open procedure and 2(25%) stent were removed in single attempt without any procedure. Conclusion: A forgotten stent is a financial burden on society, mostly impacting those who are members of the lowest level of the socioeconomic status hierarchy. Ignorance on the part of patients, along with poor counselling and a lack of follow-up by the healthcare professional, play a significant role in the development of this condition. |
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