Abstract

Background: Double DJ stents are basic tools commonly used in open & endoscopic urological procedures. Zimskind et al first introduced these stents in 1967, since then there use has increased day by day. These stents keep the ureter patent and help in prevention of ureter blockade, healing of anastomosis, restoration of edema and effective urinary drainage.

Methods: In our descriptive study we share a 2 year experience in management of 33 cases of forgotten DJ stents from April 2019 to April 2020. The study was conducted in Mayo Hospital, Unit II. Informed consent & ethical issues were taken into account. All the cases where stents were forgotten for more the 6 months were included in the study. Diagnosis was made on the basis of history, examination, CBC, Urine C/E, Urine Culture & sensitivity, USG KUB, X/ray KUB digital, Plain CT KUB 3D with renal protocol & DTPA renal scan.

Results: Out of 33 cases, 7(21.3%) were female & 26(78.7%) were male. Age range was 22 to 63 years average indwelling time of forgotten DJ stent was 1.97 year. Shortest indwelling time was 9 months, longest indwelling time was 12 years. Out of 33 cases, 5 (15.1%) were from our uni, 28 cases (84.8%) were from other hospitals . In 27(81.8%) cases stents removed endoscopically.. 7(21.21%) needed open surgery to remove the stent, out of these 6 cases, 1 underwent nephrectomy as kidney became pyelonephritic & nonfunctional. 3 cases underwent pylolithothomies, 1 underwent ureterolithotomy & 1 underwent vesicolithothomy.

Conclusion: With increasing use of DJ stent in urology, cases of forgotten DJ stent are increasing and presenting a substantial management challenge to the urologist especially in the developing countries. Lack of pre & post -operative counselling, lack of follow up, illiteracy, long distance which the patient has to travel to reach the health care facility and monetary issues are the main causes of the forgotten DJ stent.

Keywords: Forgotten DJ stent, ESWL, PCNL (Percutaneous Nephrolithotomy). URS (Ureterorenoscopy).