Ureteric stent encrustation is a significant complication of ureteric stent placement, it can prone patient to renal damage. The timely endourologic intervention has a significant role in the rescue of renal function 1,3.
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Pathology
Causes of encrustation are multifactorial which include:
- calcium or magnesium precipitation along stent pathway secondary to urinary tract infection
- chronic stone-forming patients
- pregnancy and recurrent urinary tract infections 2
Indication
Stents are indicated for both short and long term duration:
- renal calculi with ureteric obstruction
- pelvic malignancies that encasing ureter
- ureteric strictures
- retroperitoneal lymphoma and fibrosis
Complications
- stent blockage
- dislodgement of stent
- Urinary tract infection/urosepsis
Treatment and prognosis
Percutaneous nephrolithotomy, antegrade ureteroscopic calculus manipulation and extracorporeal shock wave lithotripsy are treatment options. An average of 2.5 endo-urological surgeries are required 3. Three monthly exchange of double J ureteral stents is also well established to prevent encrustation 2,3,5.
Practical points
- lost ureteral stents produce significant morbidity and mortality, secondary to widespread encrustation and fragmentation
- avoided ureteral stents are identified in urologic practice because of ignorance of patient or failure of the physician to satisfactorily advise the patient 5