Retained ureteral stents, an avoidable source of morbidity: 10 years' experience from a single tertiary care centre

Abstract

Introduction: ureteral stents are used in managing various urological conditions. When these stents are left indwelling for a prolonged time, it results in complications like stent migration, fragmentation, and encrustation. The aim of this retrospective observational study is to analyse the incidence, risk factors, and morbidity associated with retained ureteral stents. Methods: the retained/forgotten ureteral stents were defined as the stents with an indwelling period of more than six months. The records of all such patients from January 2010 to January 2020 were retrospectively reviewed. The primary reason for the placement of a stent, total indwelling time, the reason for prolonged indwelling time, and part(s) of the stent encrusted were retrospectively reviewed. Single/multistage endourological procedures were used to make the patients remove the retained stents and stone free. The type, number of procedures, and total number of sessions needed were noted. Results: data of 114 patients was reviewed retrospectively. Most patients presented with abdominal pain (62 patients, 54.4%), and dysuria (41 patients, 35.1%). An average of 1.7 sessions (range 1-4) were needed to make the patients’ stent and stone free. During these sessions, single/multiple procedures (endoscopic/open/combined) were performed. Nine patients (7.9%) had permanent loss of renal unit function and who needed a nephrectomy. Poor compliance (45.6%), unawareness (35.1%), and misconception that the stent would last a lifetime (12.3%), were the most common reasons for retained ureteral stents. The incidence rate of retained stents fell from 1.1% to 0.5% after the “three steps” prevention check method was in-cooperated to ensure timely follow-up of the patients. Conclusion: retained ureteral stents are a significant source of morbidity, which is avoidable by ensuring timely removal. Sincere efforts should be made to make patients aware of an indwelling foreign body. Prevention is the best strategy.