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Journal of Education, Health and Sport

Severe calcification of forgotten Double-J ureteral stent in a patient with undiagnosed hyperparathyroidism
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Severe calcification of forgotten Double-J ureteral stent in a patient with undiagnosed hyperparathyroidism

Authors

  • Magdalena Ostrowska Department of Urology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Bydgoszcz
  • Szymon Kaczyński Department of Urology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Bydgoszcz
  • Dominika Skwara Department of Urology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Bydgoszcz
  • Magdalena Grześk-Kaczyńska Department of Urology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Bydgoszcz
  • Adam Ostrowski Department of Urology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Bydgoszcz
  • Tomasz Drewa Department of Urology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Bydgoszcz

DOI:

https://doi.org/10.12775/JEHS.2022.12.06.008

Keywords

double-J stent, JJ stent, forgotten stent, endourology, urolithiasis, hyperparathyroidism

Abstract

Background

Double J stent (DJ) is widely used in urological practice in patients with renal stones. However, its application is related to the risk of incrustation. We present a case of severe calcification of forgotten DJ in a patient with previously undiagnosed hyperparathyroidism (HPT).

Case presentation

A 30-year-old female was admitted to the Urology Department with renal colic. An initial kidney, ureter, and bladder X-ray revealed a completely calcified DJ catheter placed twelve months earlier. Unfortunately, the patient did not show up for a follow-up visit, and stent removal was not performed.  Due to the extent of the disease, the patient was qualified for multistage endoscopic treatment. Total treatment lasted six months and consisted of five urereroscopies and one hybrid procedure. Simultaneously, diagnostics of a metabolic cause of the advanced stone disease suggested primary hyperparathyroidism, confirmed during parathyroid scintigraphy. After urological treatment had been completed, parathyroidectomy was performed. During a further 7-year follow-up, only one episode of renal colic occurred within the first year after treatment. The patient is stone-free until the present day.

Conclusions

Stents are designed to last usually up to six months, but they should be removed as quickly as possible after finishing treatment. Also, other causes such as a metabolic or hormonal imbalance should be considered. In our patient combination of forgotten DJ and HPT was the reason for excessive stone formation. Selective removal of the parathyroid gland was effective in the presented patient, with no stone recurrence observed.

References

Polat, H., M.O. Yucel, M.M. Utangac, C. Benlioglu, A. Gok, A. Cift, et al., Management of Forgotten Ureteral Stents: Relationship Between Indwelling Time and Required Treatment Approaches. Balkan Med J, 2017. 34(4): p. 301-307. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5615961/

Mollerup, C.L., P. Vestergaard, V.G. Frokjaer, L. Mosekilde, P. Christiansen, and M. Blichert-Toft, Risk of renal stone events in primary hyperparathyroidism before and after parathyroid surgery: controlled retrospective follow up study. BMJ, 2002. 325(7368): p. 807. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC128947/

Arenas, J.L., J.K. Shen, M. Keheila, S.R. Abourbih, A. Lee, P.K. Stokes, et al., Kidney, Ureter, and Bladder (KUB): A Novel Grading System for Encrusted Ureteral Stents. Urology, 2016. 97: p. 51-55. https://pubmed.ncbi.nlm.nih.gov/27421780/

Acosta-Miranda, A.M., J. Milner, and T.M. Turk, The FECal Double-J: a simplified approach in the management of encrusted and retained ureteral stents. J Endourol, 2009. 23(3): p. 409-15. https://pubmed.ncbi.nlm.nih.gov/19265471/

Guner, E. and K.G. Seker, Comparison of Two Different Scoring Systems in Encrusted Ureteral Stent Management: A Single-Center Experience. Urol J, 2020. 17(3): p. 248-251. https://journals.sbmu.ac.ir/urolj/index.php/uj/article/view/5516

Barreiro, D.M., J.B. Losada, F.C. Montiel, and N. Lafos, Urinary Incontinence and Urosepsis due to Forgotten Ureteral Stent. Urol Case Rep, 2016. 8: p. 63-5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4983102/

Bultitude, M.F., R.C. Tiptaft, J.M. Glass, and P. Dasgupta, Management of encrusted ureteral stents impacted in upper tract. Urology, 2003. 62(4): p. 622-6. https://pubmed.ncbi.nlm.nih.gov/14550429/

Jarry, E., M. Garot, F. Marliere, J.C. Fantoni, A. Villers, G. Lebuffe, et al., Predictive factors of postoperative septic complications after flexible ureteroscopy for urinary stones. Prog Urol, 2021.

Schuster, T.G., B.K. Hollenbeck, G.J. Faerber, and J.S. Wolf, Jr., Complications of ureteroscopy: analysis of predictive factors. J Urol, 2001. 166(2): p. 538-40. https://pubmed.ncbi.nlm.nih.gov/11458062/

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Published

2022-05-05

How to Cite

1.
OSTROWSKA, Magdalena, KACZYŃSKI, Szymon, SKWARA, Dominika, GRZEŚK-KACZYŃSKA, Magdalena, OSTROWSKI , Adam & DREWA, Tomasz. Severe calcification of forgotten Double-J ureteral stent in a patient with undiagnosed hyperparathyroidism. Journal of Education, Health and Sport [online]. 5 May 2022, T. 12, nr 6, s. 87–93. [accessed 24.3.2023]. DOI 10.12775/JEHS.2022.12.06.008.
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Issue

Vol. 12 No. 6 (2022)

Section

Case Reports

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Copyright (c) 2022 Magdalena Ostrowska, Szymon Kaczyński, Dominika Skwara, Magdalena Grześk-Kaczyńska, Adam Ostrowski , Tomasz Drewa

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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0

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