Ureteral stents are effectively used in the management of a variety of urinary tract diseases and the results are overwhelmingly positive for most of the patients. Ureteral stents are hollow tubes used to treat or prevent a blockage that limits the flow of urine from the kidney to the bladder. Today ureteral stents are considered a standard and indispensable urologic tool. The human body always tends to reject foreign objects and ureteral stents are no exception. The recent developments and technology have improved the efficiency of ureteral stents but certain consequences can be anticipated with its implantation in the body. In this article, we will discuss the complications of ureteral stent placement in detail.
Urinary tract infection, malposition, and ureteral erosion are the most common complications of ureteral stent placement and the complexities of forgotten ureteral stents are more severe. Let's have a deep look into these complications faced by patients around the globe after the ureteral stent placement.
Urinary Tract Infection
This is the most common complication of ureteral stent placement. Instrumentation of a previously sterile urinary tract will cause infection as a common side effect. Antibiotic prophylaxis treatment is used to avoid urinary tract infections. If a patient is already suffering from a urinary tract infection, it is recommended to delay the
ureteral stent tracker placement.
Malposition & Migration
Malposition is a situation where the ureteral stent moves to an incorrect position relative to the initial placement. Downward or upward migration of the stent is also observed in many patients. These complications can be detected by conventional radiography or other imaging procedures. Using the proper stent length and fluoroscopic assistance during the stent placement will help to avoid malposition and migration of ureteral stent placement.
Encrustation
The presence of the ureteral stent contributes a framework for the deposition of urine constituents in the urinary tract and eventually, encrustation will occur. The encrustation of ureteral stents is inevitable over time and patients can only delay the process by dilution of the urine with high fluid intake. This ureteral stent placement complication will result in the deposit of crystalline material at the renal or bladder end of the stent. ESWL, percutaneous lithotomy, cystoscopiclithopaxy, and open surgical techniques are used to treat encrustation complications.
Stent Tracker Fracture
The materials used in the stent manufacture can be brittle and fractured after prolonged use. Polyethylene was used previously for stent manufacture but it was abandoned after stent fracture was reported widely. Encrustation also plays a role in
stent tracker fracture and close monitoring is required to avoid this complication.
Ureteral Erosion or Fistulization
Fistulization is a rare complication observed in patients undergone ureteral stent placement. The erosion of the ureteral stent into adjacent structures, especially the arterial system is a complicated situation. This complication is difficult to diagnose using clinical examination or any imaging procedure. Open surgical techniques and interventional radiologic techniques are combined to treat the ureteral erosion complication after stent placement.
Forgotten Stent Tracker
Ureteral stent placement in patients requires continuous monitoring while it is in place. The longer the stent remains in the human body, the chances of complications will increase. Periodic exchange and removal of ureteral stents are required depending upon the condition of the patient. Cystoscopy and open surgeries are the common methods used to remove a stunt and in rare cases, stents are forgotten inside the body and it will lead to serious complications listed below.
- Urinary infection
- Stents encrustation
- Stents fragmentation
- Complicated procedures to remove the stunt.
- Refixation of a new stent by open surgery.
Conclusion
Ureteral stent placement treatment is associated with significant complications. Proper monitoring and extra care are mandatory for patients undergoing stent placement. The complication can be devastating in cases like a forgotten stent and it is important to promptly remove the stent when no longer needed. Most of the complications of
ureteral stent tracker placement can be reduced by high fluid intake, punctual evaluation of clinical complaints, and proactive treatment of urinal infection.
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