The placement of a stent is a routine task for urologists worldwide. The responsibility to remove this stent also rests on their shoulders. Statistically, however, about 13% of stents are forgotten - with far-reaching consequences for the patients and beyond.
In Germany, a 32-year-old Albanian female patient underwent an emergency Caesarean section. During the procedure, the ureter was injured on the right side so that a urologist is consulted. The young woman received a JJ stent.
Four, six and eight months after birth, the patient suffers recurrent UTI. After the eight-month, hematuria is noticeable for the first time. As the patient also shows symptoms of constant bladder involvement and complains of pain, she is referred to urology again.
During the further examination, the stent placed at during the C-section surgery but then forgotten is finally discovered. Meanwhile, the upper part of the imaging shows clear incrustations. These prevent the stent from being removed in one operation. Instead, the patient first receives a shock wave lithotripsy to dissolve the incrustations. Fourteen months after birth, the urologists finally remove the forgotten stent.
Until then, however, the young woman suffered from constant pain, recurrent UTI and had to undergo two surgeries and three lithotripsy. Since this time was very stressful for her, she could not establish a good connection to her newborn child and caused additional behavioral disorders, according to her own statement.
Such a case can affect the patients and the attending physician. A forgotten stent and its consequences should not be underestimated. There are concrete health risks, which is why a forgotten stent can quickly be interpreted as malpractice.
Approximately 13% of stents are forgotten following a procedure. Even more, 10 of these 13 per hundred stents encrust over time, so that sooner or later they become symptomatic. Patients with previous stone diseases, UTI and pregnant women have a particularly high risk of incrustations on the stent.
Stents with already existing incrustations cannot usually be removed without at least two operations. One in nineteen forgotten stents is even fatal for the patients concerned.
Due to the health risk for the patients, it makes sense to introduce a reliable standard program to ensure that no stent is forgotten.
The following possibilities are available, for example, in practice:
In addition, it is quite easy and quick to make an appointment with the patient shortly after a stent is placed to remove it.
Plenary Session 2 "Nightmare Session: Stones", EAU 2019, Barcelona