Introduction and Objectives
We want to report our experience in that domain, as a retrospective study of the last 15 years.
Material and Methods
After reviewing our surgical records for the above mentioned period, we have recorded 14 cases of forgotten catheters. Unintentionally indwelling period >12 month, that have induced the catheter retention. The section criteria were the retained stent a term that defines the catheters that are impossible to be removed using the usual cystoscopic method. The catheter incrustation was the responsible phenomena of the whole induced pathology: obstruction, infection and finally urosepsis. The main goal of the treatment was to achieve the stent and stone free status. From the cases mentioned above a number of 2 was represented by solitary kidney – the most challenging to treat cases.
All the patients have been treated exclusively using endourological procedures and for some cases, ESWL was used in addition. From all the stents that we have to remove, 9 have been initially inserted in our department, the rest of 5 cases represent patients that have been admitted for the first time in our department with that particular pathology. For the inferior loop incrustation we have used the Punch lithotripsy, for the superior curl – PNL/ESWL and for the ureteral stoner rigid ureteroscopy with pneumatic-ballistic lithotripsy/ESWL.
Despite the well known major advantages of the autostatic stents, the ease of use and the increasing number of endourological procedures, there is a specific pathology that is developed due to that potentially situation. Patients have various levels of comprehension and education, but the ultimate responsibility lies on the urologist in charge. The most challenging cases to treat are represented by the patients with advanced renal failure with/without sepsis due a stent impactation on a single functional kidney. Those cases are the most challenging to treat and require a multidisciplinary approach: nephrologist, intensive care, radiologist and urologist.
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.