Forgotten double-J stent and contralateral PUJ calculus

Case contributed by Subash Thapa


Dysuria and decreased stream. History of right pyelolithotomy five years back for calculus

Patient Data

Age: 55 years
Gender: Male

Fragments of missed Double-J stent on the right renal area, pelvis (bladder) and the urethra with radiodense calculus on the left renal area.

There is a hyperdense calculus measuring 3.1x 1.5 in the left PUJ causing gross dilation of the left pelvic collecting system with cortical thinning. There is also small radiodense calculus in the lower pole calyx of left kidney.

There are multiple linear coiled hyperdense structures of various sizes within the right pelvic collecting system, urinary bladder and the urethra corresponds to broken fragments of double J stent.

There is mild to moderate right hydroureteronephrosis.

Case Discussion

Patient had calculus in the right PUJ for which he underwent right pyelolithotomy with Double-J stent insertion.

Generally, stents are left for 3-6 months in condition like obstruction from urolithiasis to maintain free passage of urine from the kidney to the bladder. If long-term stents are required replacement of stent is to be done.

This patient never came for follow-up until he had symptoms of forgotten double J stent and also develop calculus on the contralateral kidney with gross hydronephrosis after 5 years.

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