THE ROLE OF URETERAL STENTS IN CONTEMPORARY UROLOGICAL PRACTICE
Keywords:
ureteral stents, ureteral stenting, complicationsAbstract
Background: Ureteroscopy plays an important role in the diagnosis and treatment of upper urinary tract disorders. Ureteral stents represent an important adjunctive method for ensuring urinary drainage and facilitating various endourological and surgical procedures. However, their use may be associated with technical difficulties and various stent related complications.
Objective: The aim of this study was to present clinical experience with the use of ureteral stents and to analyze their indications, technical aspects of placement and removal, as well as the most common complications associated with their use.
Methods: A prospective clinical study was conducted at the Department of Urology, Medical Center Tetovo, from January 2023 to January 2026. The study included 313 patients in whom a total of 357 “JJ” ureteral stents were placed. Of the total number of patients, 173 were women and 140 were men. Repeated placement of a “JJ” stent was required in 41 patients, either once or multiple times. Diagnostic evaluation was based on clinical examination, ultrasonography, radiographic examinations, radionuclide renography, and renal scintigraphy. The indications for ureteral stenting were divided into two groups: treatment of ureteral obstruction of intrinsic or extrinsic etiology and use of the stent as an adjunctive method during surgical interventions involving the ureter, either before or after surgery. “JJ” stents ranging from 4.7 to 8 Fr in diameter and 28 32 cm in length were used. Stent placement and removal were performed retrogradely using a 21 Fr or 22 Fr cystoscope.
Results: Technical difficulties during stent placement were recorded in 5.7% of cases. Stent encrustation was observed in 4.2% of patients within the first 4 weeks, in 27.2% between 4 and 12 weeks, and in 46.3% of stents left in place for more than 12 weeks until removal. Proximal or distal stent migration was recorded in 1.8% of cases. No spontaneous stent fragmentation was observed. Sepsis developed in 5.7% of patients. Stent biocompatibility related intolerance was recorded in one female patient, requiring stent removal on the third day after placement. Complications were managed conservatively or with endoscopic intervention, depending on their clinical severity.
Conclusions: “JJ” ureteral stents play an important role in contemporary urological practice, particularly in patients with ureteral obstruction and as an adjunctive method during the surgical treatment of ureteral pathologies. Safe and effective use requires appropriate indications, individualized selection of stent diameter and length, and optimal stent indwelling duration. Adequate physician training and experience are important for minimizing technical difficulties and potential complications.
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