Treatment of complicated renal colic in patients treated by indinavir: value of double J stents

Objective : Evaluation of the treatment of complicated ureteric stones in p atients treated with indinavir. Patients and Methods : From March 1997 to May 1998 10 patients (7 males, 3 females, aged 30 to 56 years), treated by triple combination therapy for HN infection, were drained for stones attributed to indinavir (CRIXNAN(R)), w hich had become obstructive and complicated. The duration of treatment with indinavir ranged from 14 days to 2 years. No patient had a history of urological disease. One patient presented with bi lateral stones. All patients presented complicated clinical features :fever in 3 cases; severe pain in 8 cases, with delayed excretion more than 4 hou rs on IVU in 6 cases. All stones were radiolucent except for one slightly r adioopaque stone. The stone was situated in the lumbar ureter in 3 cases, i liac ureter in I case and pelvic ureter in 8 cases. Results : In 10 out of II cases, a double J stent was inserted preceded by drainage by simple ureteric catheter (infected urine) in I case and by perc utaneous nephrostomy (PCN) with antegrade insertion of the stent (failure o f the retrograde route) in I case. No complementary stone fragmentation or extraction treatment was necessary after this procedure. Stents were left i n place for 3 to 7 weeks. In one case, a stone of the lumbar ureter required PCN followed by extracor poreal lithotripsy. Conclusion : In the case of complications requiring a urological procedure, insertion of a double J stent allows curative treatment of very friable in dinavir stones, which are fragmented by passage of the stent.