Current management of severely encrusted ureteral stents with a large associated stone burden

Purpose: We review our recent experience with encrusted retained ureteral s tents associated with a large stone burden as well as current endoscopic op tions available for management. Materials and Methods: One man and 3 women presented to our department betw een May 1998 and April 1999 for treatment of an encrusted retained ureteral stent. One patient had a history of 3 episodes of ureteral stent encrustat ion during the last 6 years. We reviewed the management of these stents and the associated stone burden. Results: Average patient age was 32.5 years (range 25 to 41). Average inter val that the encrusted stent remained in place was 7 months (range 3 to 12) . In the 3 women pregnancy was associated with the retained stent. All pati ents required 2 to 6 endourological approaches (average 4.2) performed at 1 or multiple sessions to render them stone-free and stent-free. Postoperati vely sepsis in 1 case necessitated a prolonged intensive care unit stay wit h eventual recovery. Conclusions: Successful management of a retained encrusted stent requires c ombined endourological approaches. Percutaneous nephrostolithotomy and uret eroscopy are often necessary for treating a severely encrusted stent and th e associated stone burden.