Endourologic Management of Severely Encrusted Ureteral Stents
Bannakij Lojanapiwat, MD*
Affiliation : * Division of Urology, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai
Background : Ureteral stents are in common use in urologic practice. Even though the stent is a valuable
urological tool, its use has two widely encountered complications, namely, stent encrustation and stone
formation. These complications are difficult to manage; but endourologic surgery, which is minimally inva-
sive, has become the first choice in the treatment for encrustation and stone formation.
Materials and Methods : Eight patients with severely encrusted ureteral stents were treated by endourologic
techniques. One patient had severe encrustation at all sites of the stent and was treated by percutaneuos
nephrolithotomy, ureteroscopy with intracorporeal lithotripsy and cystolitholapaxy. Five patients with
severe encrustation at both ends of the stent were treated with percutaneous nephrolithotomy and
cystolitholapaxy(4 cases) and with extracorporeal shock wave lithotripsy (ESWL) and cystolitholapaxy. The
last two patients with severely encrusted ureteral stents at the bladder end were treated with percutaneous
cystolithotomy with intracorporeal lithotripsy and by optical lithotrite,respectively.
Results : All cases were stone free and stent free in one session without complication. The average approaches
were 1.9 (range 1-3). All stents were removed intact and no subsequent stent was required following the
removal of the problematic stent.
Conclusion : Endourologic surgery which is minimally invasive surgery, is the first choice of treatment for the
management of severely encrusted ureteral stents with good results in one session without complications and
no subsequent stent is necessary.The authors recommend removing the stent as soon as possible or change the
new stent every 3 months for decreasing the incidence of these complications.
Keywords : Severely encrusted ureteral stent, Endourologic management.
