Fauzi Muhammad Fachri, Djojodimedjo Tarmono, Renaldo Johan
Department of Urology, Dr. Soetomo Hospital, Faculty of Medicine, Airlangga University, Surabaya, Indonesia.
Radiol Case Rep. 2024 Aug 24;19(11):5216-5220. doi: 10.1016/j.radcr.2024.07.148. eCollection 2024 Nov.
Implementing double-J (DJ) stents in urological practice helps to alleviate kidney and ureteral obstruction. The primary causes of neglecting a DJ stent typically involve inadequate counseling and poor patient compliance. Encrustations of neglected DJ stents present a significant challenge. This study aims to report on a neglected DJ stent that persisted for 3 years, presenting as giant bladder and ureteral stones. We report on a 35-year-old male with chief complaints of discomfort in the suprapubic and left flank, along with concurrent micturition leakage. He had a DJ stent implanted to treat his ureteral stone 3 years ago. Advanced imaging showed a left distal ureteral stone (0.7×0.8×1.9 cm), extensive hydronephrosis and hydroureter, and a bladder stone (4.7×3.9×3.2 cm). A left ureterorenoscopy (URS) was done to remove a stone from the end of the ureter, half of a DJ stent and a bladder calculus using cystolitholapaxy. However, the patient underwent a second surgery owing to a residual bladder stone. The patient was discharged from the hospital without any symptoms. A foreign object in the urinary tract, like a DJ stent, may create secondary calculi. Endoscopic treatment could improve the efficacy of treating large bladder stones simultaneously with ureteral stones. As a measure to prevent DJ stent-related complications, it is also essential for healthcare professionals to provide information and follow-up care to patients regarding the use of DJ stents.
在泌尿外科实践中植入双J(DJ)支架有助于缓解肾和输尿管梗阻。忽视DJ支架的主要原因通常包括咨询不足和患者依从性差。被忽视的DJ支架结壳带来了重大挑战。本研究旨在报告一例持续3年的被忽视的DJ支架,表现为巨大膀胱结石和输尿管结石。我们报告一名35岁男性,主要症状为耻骨上和左侧胁腹不适,同时伴有排尿漏。他3年前植入DJ支架以治疗输尿管结石。先进影像显示左输尿管远端结石(0.7×0.8×1.9厘米)、广泛肾积水和输尿管积水以及膀胱结石(4.7×3.9×3.2厘米)。进行了左侧输尿管肾镜检查(URS),以使用膀胱碎石术从输尿管末端取出结石、半个DJ支架和一枚膀胱结石。然而,由于残留膀胱结石,患者接受了二次手术。患者出院时无任何症状。尿路中的异物,如DJ支架,可能会形成继发性结石。内镜治疗可提高同时治疗大膀胱结石和输尿管结石的疗效。作为预防DJ支架相关并发症的一项措施,医护人员向患者提供有关DJ支架使用的信息和随访护理也至关重要。