Long-Term Complications of Neglected Double-J Stent With Renal and Bladder Stone Formation: A Case Report From Sudan

Abstract

Double-J (DJ) stents are commonly used to maintain ureteral patency after procedures like ureteral stone removal. Ideally, they should be replaced or removed within 6 to 12 weeks to avoid complications such as encrustation and stone formation. However, prolonged retention can lead to severe outcomes. This case report discusses a patient with a neglected DJ stent, which resulted in both renal and bladder stones. A 35-year-old Sudanese woman presented with right loin pain and dysuria. She had a DJ stent inserted 4 years ago after ureteroscopy for ureteral stone removal but did not follow up due to insufficient knowledge about the stent. Imaging revealed renal and bladder stones with significant encrustation. Transurethral cystolitholapaxy was performed successfully for the bladder stone. However, attempts to remove the DJ stent endoscopically were unsuccessful due to a large renal pelvic stone attached to the stent. The patient underwent pyelolithotomy to remove the stone together with the retained DJ. One month later, she had no complications and returned to normal activities. The lack of follow-up and understanding of the DJ stent led to complications. Extended stent retention increases the risk of encrustation and stone formation. Treatment often involves a multiple operations, including pyelolithotomy and endoscopic procedures, especially in resource-limited settings. This case highlights the need for comprehensive patient education, timely stent removal, and regular follow-up to prevent devastating complications from neglected DJ stents. It also emphasizes the importance of tailored treatment strategies in resource-constrained environments.