被遺忘的雙J導管完全隱藏在巨大的膀胱結石中之案例報告

梁柏崧、林奇柏

彰化基督教醫院 外科部 泌尿外科

Forgotten double J stent entirely concealed among the large vesical stone: A case report

Po-Sung Liang, Chi-Bo Lin

Division of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan

Introduction: Forgotten double J stent with stone encrustation, though uncommon, continues to occur in urological practice. The removal may occasionally challenging. We presented a case of a retained double J stent discovered within a large vesical stone.

Case presentation: A 63-year-old male underwent a ureteroscopic operation with double J stenting around 20 years ago. He experienced lower urinary tract symptoms in recent years. Open cystolithotomy was recommended at another hospital, but he was hesitant and sought a second opinion at our facility. X ray revealed a 6.2 cm big vesical stone, resembling a typical stone without evidence of double J stent inside (Fig. 1). The endoscopic cystolitholapaxy was executed smoothly. An elastic tubular material was observed during the operation (Fig. 2). As lithotripsy advanced, the double-J stent gradually became apparent. Ultimately, shattered stones were extracted, and the entire double J stent was withdrawn (Fig. 3). Five days later, the patient returned to our outpatient department, and the follow-up X-ray revealed the absence of stones.

Conclusions: The ureteral double J stent is a frequently executed urological procedure. While there exists a broad range of perspectives on the appropriate duration for the removal of ureteral stents, prolonged placement of a ureteral double J stent may elevate the chance of stone encrustation. A forgotten double J stent may lead to numerous issues, including stent migration and stone formation, typically resulting from human factors. To prevent this issue, a reminder system emphasizing to enhance patient compliance should be implemented.