1. Complications of Double-J Stent of the Ureter: Single Centre Experience
M S Al Marhoon, O Shareef, K Prasad Sultan Qaboos University - Oman
Introduction
Results
Conclusions
Indications for stent placement (Fig.1)
On univariate analysis significant factors
affecting complications were patient sex (P < 0.001), indication for stenting (P = 0.008), stent duration interval (P = 0.002), stent length (P = 0.046), and positive urine culture post stenting (P < 0.001)
affecting the outcome after stenting (improved or not) were patient age (P = 0.002), sex (P = 0.009), indication for stenting (P < 0.001), stent duration interval (P < 0.001), stent length (P = 0.02), stent diameter (P = 0.002), and positive urine culture pre (P = 0.016) and post (P = 0.013) stenting
On multivariate analysis, the significant independent factors (Table 1)
affecting the improved outcome was age (P = 0.014) (Fig. 2)
affecting complications was the stent length (P = 0.016) (Fig. 3)
Ureteral stents have been first described by Zimskind et al in 1967
Reported major complications in the literature after ureteral stent placement include:
vesico-ureteric reflux
urinary infection, Pyuria, incontinence
inadequate relief of obstruction
ureteral erosion or fistulization
forgotten stent, necrosis
Stent fracture, encrustation
Stent migration, malposition
Longer stents are associated with increased complications
The older the patient the more likely to have poor outcome after stenting
Stent size did not affect complications or outcome
Future prospective multicenter studies with larger number of patients are needed to affirm the present conclusions
Migration
Stent fracture
Fig.1: Stent Indications
Fig. 3: Longer stents increase the complications
Malposition
Encrustation
Table1: Factors affecting patient’s complications and outcome (Multivariate analysis)
Objectives
References
To determine factors affecting the development of complications and the outcome of stenting
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Akay AF, Aflay U, Gedik A, Sahin H, Bircan MK: Risk factors for lower urinary tract infection and bacterial stent colonization in patients with a double J ureteral stent. Int Urol Nephrol 2007;39:95-98.
Fig. 2: Older patients are more likely to have poor outcome after stenting
Methods
220 patients (133 males and 87 females) with a mean age of 39.5 ± 15.4 years who underwent fixation of self-retaining ureteral stents in our center were included in the study
Univariate and multivariate analyses were carried out to determine significant variables affecting the development of complications and the outcome of stenting (condition improved or not improved)
Correspondent: Dr. Mohammed S Al Marhoon, Urology Division, Department of Surgery, College of Medicine & Health Sciences, Sultan Qaboos University, P.O. Box 35, Al-Khoud 123,
Sultanate of Oman,