A case report on the management of neglected and forgotten DJ stent for 15 years with severe encrustation and multiple renal and bladder stones

INTRODUCTION AND IMPORTANCE: The placement of ureteral DJ stents is currently regarded as a common and indispensable urologic tool (Dyer et al., 2002 [1]). However, using them can lead to complications. Infection, stent migration, encrustation, stone formation, and stent fragmentation are some of these complications (Mahmood et al., 2018 [2]). Stent-related complications are inversely associated with time (Lombardo et al., 2022 [3]). In this case report, we present multimodal therapy, which also includes open surgery and endourologic procedures for the removal of severely encrusted DJ stents. CASE PRESENTATION: A 22-year-old male who underwent nonspecific flank surgery 15 years ago, had a stent placed, and was lost to follow-up. He had severe stent encrustation at the presentation. He also had a solitary bladder stone and many pelvic stones discovered. Initially, cytolithotrity and semirigid ureteroscopy with laser lithotripsy were performed, and the encrusted stent was removed. Subsequently, an open cytolitotomy was done. Followed by an ultrasound-guided PCNL at which time the remaining stones were removed. The patient was followed for eighteen months and has been in better condition. DISCUSSION: The key risk factor for the development of encrustation has been shown repeatedly to be the duration of stent indwelling time (Lombardo et al., 2022 [3]). In the absence of clear guidelines for the removal of retained stents, this problem has been approached with a variety of treatment modalities (Bidnur et al., 2016 [4]). A stepwise approach with combined endo-urology and open surgery can be used for the management. CONCLUSION: Forgotten and neglected DJ stentsfor a long time can cause multiple complications. The best treatment is the prevention of this complication with a stent registry and increase awareness among the patients and their attendants.