More often than thought: the forgotten stent

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.

Forgetting a stent is increasingly being considered malpractice in court cases

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.

A starting point

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.

Unfortunately, forgotten stents are not uncommon

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.

How do you make sure that the stent is not forgotten?

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. 

Source:
Plenary Session 2 "Nightmare Session: Stones", EAU 2019, Barcelona

esanum is an online network for approved doctors

esanum is the medical platform on the Internet. Here, doctors have the opportunity to get in touch with a multitude of colleagues and to share interdisciplinary experiences. Discussions include both cases and observations from practice, as well as news and developments from everyday medical practice.

esanum ist ein Online-Netzwerk für approbierte Ärzte

esanum ist die Ärzteplattform im Internet. Hier haben Ärzte die Möglichkeit, mit einer Vielzahl von Kollegen in Kontakt zu treten und interdisziplinär Erfahrungen auszutauschen. Diskussionen umfassen sowohl Fälle und Beobachtungen aus der Praxis, als auch Neuigkeiten und Entwicklungen aus dem medizinischen Alltag.

Esanum est un réseau en ligne pour les médecins agréés

esanum est un réseau social pour les médecins. Rejoignez la communauté et partagez votre expérience avec vos confrères. Actualités santé, comptes-rendus d'études scientifiques et congrès médicaux : retrouvez toute l'actualité de votre spécialité médicale sur esanum.