Spontaneous Fragmentation and the Disappearing JJ Stent: A Case Series and Review of the Literature

TL;DR

This paper discusses complications from long-term use of urinary stents, including fragmentation and difficulty in removal, based on two case studies and a literature review.

Contribution

The novelty lies in presenting two unique clinical cases of long-retained stents and exploring mechanisms of stent degradation.

Findings

Stents left in place for over three years can fragment and become difficult to remove.

In one case, the stent completely disappeared without causing symptoms.

Complicated ureteroscopy was needed to remove fragmented stents in another case.

Abstract

When double J urinary stents are “forgotten,” their constituent polymers undergo mechanical and chemical degradation. This process can lead to potentially serious complications, such as encrustation or fragmentation. Fragmented and degraded stents are often more difficult to remove, frequently requiring complex surgical procedures. We present two cases of ureteric stents that were left in place for more than three years. In one case, a complicated ureteroscopy was required to remove the stent in numerous pieces. In the other case, the stents fragmented over time and completely disappeared; the patient denied experiencing stenturia. We review the evidence to identify the potential mechanisms leading to stent fracture and suggest possible preventive strategies.

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