Event Title

“Forgotten” stents in the urinary tract and procedures for their extractiion

Session

Medicine and Nursing

Description

Introduction and objectives

After the start of the aplication of ESWL, percutaneous lithotripsy and URS-lithotripsy, to manage urolithiasis , indications forthe use the “JJ” ureteral stents are not uncommon. Meanwhile, tehere is a limit time for their keeping them in, because if retained for more than 6 weeks or two months , there is a possibiity for crystalization , especially in the upper and lower parts of the “J”, where crystallization occurs very often and this makës difficult to extract them.

We present 12 cases of holding stents , lasting more than three months ( one case up to 8 years! )and how to manage them.

Material and methods

The material was taken from the protocol of the Urologic Clnic of Kosovo and Urological Polyclinic “ Pro-Ren “ in Ferizaj, during the period, from April 2017- April 2021.

We present 12 cases of calcification of ureteral stents “JJ” and how to manage them. Of these 12 cases , in the 8 cases we see calcifications occur only in the upper “J” ( pyelon); in the 2 cases, calcifications occur mainly in the lower “J”( bladder) and in 2 other cases , calcifications occured in the upper and lower “J” ( pyelon and the bladder).

Results

For the first 8 cases , we use the ESWL as a management method , where , after one or two sesssions , we managed to destroy the calcification in the upepr “J” ; in sex cases aftr two sessions os ESWL, we managed to remove the stents , while in two cases ,even aftër 4 sessions, with 4000 strokes, we did not manage to destroy the calcifications, so we had to perform the pyelolithotomy, for extracting of stents. In 2 cases with calcifications in the uper and lower “J”, we manage to destroy the cacifications with ESWL in upper “J” and with cystolithotripsy in thë lower “J” and than easly extract the stents. Two other cases, with calcifications only in the lower “J”, we applied only cystolithotripsy and the stents were removed, wiathout any difficulty.

Conclusion

We can conclude that in cases when it comes to “forgotten” stents for a long time in the urinary tract , we should use less invasive methods to managing these cases , such as ESWL and cystolithotripsy, or a combination of both. But, in some cases , we are forced to performy more invasive procedurës, which are not preferred , but are necessasry, such as pyelolithotomy , to maintain kidney function.

Proceedings Editor

Edmond Hajrizi

ISBN

978-9951-550-47-5

Location

UBT Kampus, Lipjan

Start Date

30-10-2021 12:00 AM

End Date

30-10-2021 12:00 AM

DOI

10.33107/ubt-ic.2021.175

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Oct 30th, 12:00 AM Oct 30th, 12:00 AM

“Forgotten” stents in the urinary tract and procedures for their extractiion

UBT Kampus, Lipjan

Introduction and objectives

After the start of the aplication of ESWL, percutaneous lithotripsy and URS-lithotripsy, to manage urolithiasis , indications forthe use the “JJ” ureteral stents are not uncommon. Meanwhile, tehere is a limit time for their keeping them in, because if retained for more than 6 weeks or two months , there is a possibiity for crystalization , especially in the upper and lower parts of the “J”, where crystallization occurs very often and this makës difficult to extract them.

We present 12 cases of holding stents , lasting more than three months ( one case up to 8 years! )and how to manage them.

Material and methods

The material was taken from the protocol of the Urologic Clnic of Kosovo and Urological Polyclinic “ Pro-Ren “ in Ferizaj, during the period, from April 2017- April 2021.

We present 12 cases of calcification of ureteral stents “JJ” and how to manage them. Of these 12 cases , in the 8 cases we see calcifications occur only in the upper “J” ( pyelon); in the 2 cases, calcifications occur mainly in the lower “J”( bladder) and in 2 other cases , calcifications occured in the upper and lower “J” ( pyelon and the bladder).

Results

For the first 8 cases , we use the ESWL as a management method , where , after one or two sesssions , we managed to destroy the calcification in the upepr “J” ; in sex cases aftr two sessions os ESWL, we managed to remove the stents , while in two cases ,even aftër 4 sessions, with 4000 strokes, we did not manage to destroy the calcifications, so we had to perform the pyelolithotomy, for extracting of stents. In 2 cases with calcifications in the uper and lower “J”, we manage to destroy the cacifications with ESWL in upper “J” and with cystolithotripsy in thë lower “J” and than easly extract the stents. Two other cases, with calcifications only in the lower “J”, we applied only cystolithotripsy and the stents were removed, wiathout any difficulty.

Conclusion

We can conclude that in cases when it comes to “forgotten” stents for a long time in the urinary tract , we should use less invasive methods to managing these cases , such as ESWL and cystolithotripsy, or a combination of both. But, in some cases , we are forced to performy more invasive procedurës, which are not preferred , but are necessasry, such as pyelolithotomy , to maintain kidney function.