Xiong Lin, Kwan Kristine Joy Shan, Wen Xiang-Yang, Xu Yuan-Cheng, Xu Xiang, Wei Geng-Geng
Department of Urology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, Guangdong, China (mainland).
International School, Jinan University, Guangzhou, Guangdong, China (mainland).
Am J Case Rep. 2022 Nov 20;23:e937961. doi: 10.12659/AJCR.937961.
BACKGROUND Encrustation of the ureteral stent is a common complication that occurs after a prolonged indwelling duration. Other identified risk factors in the literature include urinary sepsis, chemotherapy, chronic renal failure, metabolic or congenital abnormalities, and nephrolithiasis. This report presents the case of a 39-year-old man with nephrolithiasis and fragmentation of a calcified right ureteric stent that required ureteroscopy and laser lithotripsy. CASE REPORT A 39-year-old man was initially admitted for ureteroscopy and laser lithotripsy after the diagnosis of bilateral urolithiasis. Ureteral stents were placed. One postoperative month later, the patient returned for follow-up and stent withdrawal. Follow-up computed tomography revealed a normal left kidney, intact bilateral ureteral stents, and residual right renal stones. However, an attempt to completely withdraw the stent failed and the patient had to undergo a secondary right ureteroscopy with laser lithotripsy. The fragmented proximal section of a calcified right ureteral stent with occluded lumen was found intraoperatively and sent for product analyses. After successful reintervention, the patient had a new right ureteral stent placed, which was successfully withdrawn during his next follow-up. CONCLUSIONS Ureteral stent encrustation may occur earlier than anticipated, possibly due to underlying patient risk factors. Complications, such as fragmentation of the ureteral stent, may occur during withdrawal. Physicians should be aware of any predictors for early ureteral stent encrustation to prevent unnecessary reintervention.
输尿管支架结壳是长期留置后常见的并发症。文献中确定的其他风险因素包括尿脓毒症、化疗、慢性肾衰竭、代谢或先天性异常以及肾结石。本报告介绍了一名39岁男性肾结石患者，其钙化的右侧输尿管支架断裂，需要进行输尿管镜检查和激光碎石术。病例报告：一名39岁男性最初因双侧尿路结石诊断后入院接受输尿管镜检查和激光碎石术，并放置了输尿管支架。术后1个月，患者返回进行随访和支架取出。随访计算机断层扫描显示左肾正常，双侧输尿管支架完整，右侧残留肾结石。然而，完全取出支架的尝试失败，患者不得不接受二次右侧输尿管镜检查和激光碎石术。术中发现钙化的右侧输尿管支架近端部分断裂，管腔堵塞，并送去进行产品分析。再次干预成功后，为患者放置了新的右侧输尿管支架，在下次随访时成功取出。结论：输尿管支架结壳可能比预期更早发生，可能是由于患者潜在的风险因素。在取出过程中可能会出现输尿管支架断裂等并发症。医生应了解输尿管支架早期结壳的任何预测因素，以防止不必要的再次干预。
