Abdul Majid Rana.
Management of severly encrusted retained Stents.
Med Channel Jan ;11(2):82-4.

OBJECTIVE: To review the management of heavily encrusted and retained DJ ureteral slants. MATERIAL AND METHODS: Medical record of patients from 1996 to December 2004 was reviewed and analyzed for DJ stent complications and their final out come: 603 stents were inserted in 588 patients. 21 patients had D.J. Stant inserted because of solitary functioning kidney and 567 had DJ stent inserted as a pre or post requisite to treat renal calculi of size 1.5 cm with extra corporal shock wave lithotripsy and ureteral calculi. Out of 603 stents inserted, 82 (I3 3.59%) were found to he encrusted, of these 7 (2.8%) had slants retained "A stent is described as retained if this can not he removed at first attempt cystoscopically". To make them stent free all these patients underwent one or more of the following procedures like Cystolitholapaxy. Retrograde Ureteroscopic manipulation, Intrad corporeal lithotripsy, Extra corporeal lithotripsy and Open removal. RESULTS: 14 males and 3 females with M:F ratio of 4:6:1 with mean age of 38 years(range 23-69 years). Average duration of stent Placement was 5 months with range of 4 to 11 months. Patients had 3 to 8 sessions of extra corporeal shock wave lithotripsy with range of 4 sessions. The encrustation was localized to upper coil of DJ stent-01, in upper coil and body-02, lower coil and body II and 3 were totally encrusted. 15 of the 7 stents had their lumen totally occluded. All Patients were rendered stent free: CONCLUSION: Stent Encrustation and retention are one of the scrious complication Multimodality urological procedures and availability of various equipments should he the main stay of successful management.

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