The first report of 3 forgotten encrusted double J stents in the same ureter: An endourology nightmare!

Abstract

Introduction: The ‘encrusted and forgotten double J ureteric stent (JJ) phenomenon has always proven to be a challenging dilemma facing the attending urologist.

Observation: Herein, we describe the first reported case of 3 encrusted stents within the same ureter, with an overall KUB score of 14 (K = 5, U = 4, B = 5). Complete (stent and stone) clearance was achieved using multiple combined, endo-urological procedures (sequentially) including; bladder stone laser lithotripsy, distal JJ stent coil resections, PCNL and prograde (flexible) ureteroscopy, followed by rigid and flexible retrograde ureteroscopy. The resulting reno-gram confirmed a 45% functioning ipsilateral system

Conclusion: The first report of 3 encrusted stents within the same ureter is presented. The prevention of JJ stent encrustation is crucial via adequate and appropriate patient counselling. In most patients with forgotten encrusted stents who qualify for endoscopic management, a multi-modality approach is required

Keywords: Forgotten stent; PCNL; Stent encrustation; Haematuria; reteroscopy;  Double J stent (JJ stent)