Observational Analysis of A Retrospective Cohort on Indications and Complications of Double-J Ureteral Stents

Objectives: To report the indications for double J ureteral stents, the complications associated with them, and their management. Patients and Methods: This was a cross-sectional prospective study conducted over twelve months in the urology department of the Ibn Rochd University Hospital in Casablanca, Morocco. Included in the study were patients who were hospitalized for complications related to double J ureteral stents. The parameters studied were age, sex, indication for JJ placement, duration of stent placement, diagnosis, renal function, urine microscopic analysis, imaging (plain abdominal radiograph or uro-CT), and therapeutic approach. Data was compiled and analyzed using Excel. Results: A total of 39 patients were included in the study, 69% of whom were male. The average age of the patients was 41 years. A low socio-economic status was noted in 54% of cases. The main indication for JJ stent placement was lithiasis-related pathology. JJ stent placement was unilateral in 33 patients (14 on the right and 19 on the left) and bilateral in 6 patients. The average duration of JJ stent placement was 11 months, with a range from 4 months to 5 years. Reported complications were either infectious or mechanical. Infectious complications were the main reason for hospitalization. Treatment depended on the specific complication and included antibiotic therapy, simple stent removal or replacement, laser or lithoclast surgery (ureteroscopy or percutaneous nephrolithotomy), or open surgery. In some cases, treatment combined two different techniques. No deaths were recorded. Conclusion: With the advancement of endourology, indications for double J ureteral stents have broadened, leading to a proportional increase in reported complications. Due to the lack of clearly defined guidelines and the nature of their complications, severe JJ stent complications pose a real management challenge, requiring adaptation based on available and mastered techniques. The best therapeutic approach remains prevention. Thus, institutions�especially surgeons and patients�each have a role to play.