Unutulan DJ Stentlere Bağlı Oluşan Üriner Taşlarda Tedavi Yaklaşımları

Üreteral DJ stentler uzun yıllardır üroloji pratiğinde sıklıkla kullanılmaktadır. Artan kullanıma bağlı olarak stentle ilgili komplikasyonlarda da artış izlenmiştir ve unutulan üreteral stentler ciddi bir klinik sorun olarak karşımıza çıkabilmektedir. Bu komplikasyonlardan en sık rastladıklarımız erken dönemde ağrı ve irritatif semptomlardır. Geç dönemde ise unutulan stentlerin etrafındaki bakteriyel kolonizasyon ve biofilm tabakası taş oluşumuna zemin hazırlamaktadır. Unutulan DJ stentin tedavisi stentin lokalizasyonu, etrafında taş oluşumu gibi birçok faktöre bağlı olarak değişebilmektedir. Makalemizde unutulan iki farklı DJ stente bağlı olarak oluşan taş tedavisine klinik yaklaşımımız literatür eşliğinde tartışılması amaçlanmıştır.

Treatment Approaches to Urinary Stones Caused by Forgotten DJ Stents

Ureteral DJ stents have been used widely for years in urology practice. With increased use, complications have been increased and forgotton stents have started to cause problems. The most common complications are early pain and irritative symptoms. Late complications are bacterial colonization and stone formation because of the biofilm covering the stents. Treatment for a forgotten stent varies on many factors, such as stent localization and stone formation. In this article, we aimed to discuss our clinic approach on two different cases in light to current literature.

___

  • Finney RP. Experience with new double J ureteral catheter stent. J Urol.1978;120:678-81
  • Lange D, Bidnur S, Hoag N, Chew BH. Ureteral stent-associated complications--where we are and where we are going. Nat Rev Urol. 2015;12:17-25.
  • Damiano R, Oliva A, Esposito C, De Sio M, Autorino R, D'Armiento M. Early and late complications of double pigtail ureteral stent. Urol Int. 2002;69:136-40
  • Joshi HB, Newns N, Stainthorpe A, MacDonagh RP, Keeley FX Jr, Timoney AG. Ureteral stent symptom questionnaire: development and validation of a multidimensional quality of life measure.J Urol. 2003;169:1060-4.
  • Withington J, Wong K, Bultitude M, O'Brien T. The forgotten ureteric stent: what next? BJU Int. 2014;113:850-1.
  • Joshi HB, Chitale SV, Nagarajan M, Irving SO, Browning AJ, Biyani CS, Burgess NA. A prospective randomized single-blind comparison of ureteral stents composed of firm and soft polymer . J Urol. 2005;174:2303-6.
  • Jones D.S., Djokic J., Gorman S.P. Characterization and optimization of experimental variables within a reproducible bladder encrustation model and in vitro evaluation of the efficacy of urease inhibitors for the prevention of medical device-related encrustation. J Biomed Mater Res B Appl Biomater. 2006;76:1–7.
  • Laube N, Kleinen L, Bradenahl J, Meissner A. Diamond-like carbon coatings on ureteral stents--a new strategy for decreasing the formation of crystalline bacterial biofilms? J Urol. 2007;177:1923- 7.
  • Hildebrandt P, Sayyad M, Rzany A, Schaldach M, Seiter H. Prevention of surface encrustation of urological implants by coating with inhibitors. Biomaterials. 2001;22:503–7.
  • Chew BH, Paterson RF, Clinkscales KW, Levine BS, Shalaby SW, Lange D. In vivo evaluation of the third generation biodegradable stent: a novel approach to avoiding the forgotten stent syndrome. J Urol. 2013;189:719-25.
  • Rabani SM. Combined Percutaneous and Transurethral Lithotripsy for Forgotten Ureteral Stents With Giant Encrustation. Nephrourol Mon. 2012;4:633-5.
  • Singh V, Srinivastava A, Kapoor R, Kumar A. Can the complicated forgotten indwelling ureteric stents be lethal? Int Urol Nephrol. 2005;37:541-6.
  • Bardapure M, Sharma A, Hammad A. Forgotten ureteric stents in renal transplant recipients: Three case reports. Saudi J Kidney Dis Transpl. 2014;25:109-12.
  • Lynch MF, Ghani KR, Frost I, Anson KM. Preventing the forgotten ureteral stent: implementation of a web- based stent registry with automatic recall application. Urology. 2007;70:423-6.
Cukurova Medical Journal-Cover
  • ISSN: 2602-3032
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1976
  • Yayıncı: Çukurova Üniversitesi Tıp Fakültesi