Management of Forgotten, Encrusted, and Fragmented Double-J Ureteral Stents: A Prospective Cross-Sectional Observational Study from a Tertiary Care Center.

Abstract

Background:

Forgotten, encrusted, and fragmented double-J ureteral stents represent a preventable yet clinically demanding urological problem. Delayed retrieval increases the risk of stone formation, infection, fragmentation, and the need for combined endourological procedures.

Objectives:

To evaluate the clinical presentation, pattern of stent encrustation or fragmentation, management strategies, and short-term outcomes among patients treated for forgotten double-J ureteral stents at a tertiary care center.

Methods:

This prospective observational study included 22 consecutive patients managed at A C Subba Reddy Government Medical College & Hospital, Dargamitta, Nellore, Andhra Pradesh, India, from April 01, 2026, to April 30, 2026. Demographic details, symptoms, stent duration, imaging findings, operative procedures, complications, and clearance outcomes were analysed descriptively.

Results:

The mean age was 43.6 ± 12.8 years, and females constituted 54.5% of the cohort. The mean retained stent duration was 19.4 ± 9.7 months. Flank pain was the most frequent symptom. Encrusted-only stents were seen in 59.1%, while 27.3% had both encrustation and fragmentation. Ureteroscopy, cystolithotripsy, retrograde intrarenal surgery, and percutaneous nephrolithotomy were used according to encrustation burden. Complete stent clearance was achieved in all patients, with stone-free status in 90.9%.

Conclusion:

Multimodal endourological management provided high clearance with acceptable morbidity in patients with forgotten, encrusted, and fragmented double-J stents.

Recommendations:

Structured stent registries, patient counselling, and reminder systems should be implemented to prevent prolonged indwelling time and reduce avoidable complications.