Spontaneous Fragmentation of a DJ Stent Forgotten for Five Years: A Case Report

Our patient presented with acute urine retention. He had a history of having had a DJ stent insertion, and it had been forgotten for 5 years. This situation was made possible by the facts that the patient was illiterate, lived alone and the hospital had no tracking system for patients of DJ stent insertions. An X-ray showed a fragmented stent and that parts of the stent had migrated to the urethra with heavy encrustations around the lower coil. The patient was unable to cooperative with the insertion of a suprapubic catheter, so he was taken to the operating room. Under spinal anesthesia, the fragmented parts of the DJ stent were gently pushed into the urinary bladder, then crushed, and removed with a mechanical lithotripter. Following this surgery, the patient had 3 sessions of Extracorporeal Shockwave Lithotripsy (ESWL). This way the stent and stones were broken up and removed using both a rigid ureteroscopy and a flexible ureteroscopy with a laser lithotripter. In those cases where hospitals do not track patients with DJ stents, we recommend special attention be given to patients who might be unable to report issues, such as for those patients who live alone, those patients with low social economic levels and thus fewer financial resources, and include those whose circumstances limit their mental abilities.