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Endoscopic management of encrusted ureteral stents: outcomes and tips and tricks

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Abstract

Purpose

To report our experience in the management of encrusted ureteral stents (EUS) and provide technical insight of our endourological approaches for difficult scenarios posed by this entity.

Materials and methods

A retrospective evaluation of a longitudinally collected database of 58 patients with encrusted US between December 2012 and May 2022 was performed. The ureteral stents were initially inserted due to obstructive uropathy, pyelonephritis or after a successful endoscopic procedure for urolithiasis. A combination of antegrade/retrograde treatment in single or multiple sessions took place for the retrieval of the encrusted stents. Non-contrast enhanced computer tomography was used for the follow-up of the patients at 1-month after the removal of the encrusted stent.

Results

Overall 58 patients, 39 males and 19 females with a median age of 51 years old were included in the study. Indwelling time was < 6 months, 6–12 months and > 12 months in 22%, 57% and 21% of the cases, respectively. All US were successfully removed. Semi-rigid ureteroscopy (URS) and flexible ureteroscopy (fURS) were used in 90% of the cases. In 10% of the cases, a second-stage percutaneous nephrolithotomy (PCNL) or endoscopic combined intrarenal surgery (ECIRS) was performed. All US were successfully released. Stone-free rate was 84% at 1-month. Overall complication rate was 10.5% (mostly postoperative fevers, 5.4%).

Conclusion

Removal of the encrusted US is a challenging procedure. Appropriate decision-making and knowledge of specific tricks may result in safe and successful management of significant EUS.

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Data availability

The data of the current study can not be available.

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Funding

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Author information

Authors and Affiliations

  1. Department of Urology, University of Patras Medical School, Rio, 26500, Patras, Greece

    Arman Tsaturyan, Angelis Peteinaris, Marco Lattarulo, Begona Ballesta Martinez, Evangelos Liatsikos & Panagiotis Kallidonis

  2. Department of Urology, Erebouni Medical Center, Yerevan, Armenia

    Arman Tsaturyan

  3. Department of Urology, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal

    Gabriel Faria-Costa

  4. Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal

    Gabriel Faria-Costa

  5. Department of Anesthesiology and ICU, University of Patras, Patras, Greece

    Theofanis Vrettos

  6. Department of Urology, Medical University of Vienna, Vienna, Austria

    Evangelos Liatsikos

Authors
  1. Arman Tsaturyan
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  2. Gabriel Faria-Costa
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  4. Marco Lattarulo
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  7. Evangelos Liatsikos
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Contributions

AT: data collection and data analysis, manuscript drafting. GFC: data analysis; manuscript drafting. AP: data collection, critical revision. ML: data collection, critical revision. BBM: data collection, critical revision. TV: data collection, critical revision. EL: study design and conception, interpretation of data and critical revision. PK: study design and conception data analysis, interpretation of data and critical revision.

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Correspondence to Arman Tsaturyan.

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The authors declare no conflict of interest.

Ethical approval

The study has been carried out in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All patients gave their written consent for the surgery. A separate consent was received from patients, whose data were used for the construction of a video material.

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Tsaturyan, A., Faria-Costa, G., Peteinaris, A. et al. Endoscopic management of encrusted ureteral stents: outcomes and tips and tricks. World J Urol 41, 1415–1421 (2023). https://doi.org/10.1007/s00345-023-04361-8

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