Forgotten Double-J Ureteral Stent

Abstract

Since the article of Zimsking, 1967, that described the use of a silicon ureteral splint to unblock the renal-ureteral unit, the double J catheter is being routinely used in several urological procedures, particularly in those with obstruction due to urinary stones, urogynecological tumors, urinary stenosis and retroperitoneal fibrosis (1). It can also be used following ureteral lesions or to reduce the risk of inadvertent trauma during complex abdominal and pelvic surgeries (2). Many patients are treated only with the double J catheter and in others the drainage of the urinary system may postpone definitive treatment for a better moment, particularly in the presence of infection. There are some negative side effects of its use such as discomfort and alteration of micturition, hematuria, perineal and genital pain, and the occurrence of urinary infections or even pyelonephritis (3). New catheters are being developed, with different designs, width, length, material, flexibility, in order to minimize these symptoms. Other clinical studies have evaluated drugs that can ameliorate the clinical setting, such as anticholinergics, alpha-blockers and analgesics. However, more severe complications are observed with forgotten catheters at the urinary system, that encrust, form stones, fragment, “stenturia” and encrust with obstruction and loss of renal function (4, 5-7). These cases are complex and require multiple endo-urological procedures in order to remove the catheter and the associated stones, including shock wave lithotripsy, perVol. 45 (6): 1087-1089, November December, 2019