Objective: To review morbidity and late complications of ureteral stent insertion and to specifically evaluate hydronephrosis as a radiologic finding of obstruction in the presence of an indwelling ureteral stent.Methods: In this prospective study, we evaluated 110 stented kidneys in a group of 90 patients. Of 110 stents, 52 were left in place for 3 months, 23 for 6 months, 11 for 9 months, and 24 for up to 12 months. With the stent in place, patients were followed by plain abdominal X–ray 1 and 30 days after stenting. Further follow–up was performed through ultrasound and plain film every 3 months until scheduled date for stent removal or the appearance of complications.Results: In 11 of 110 cases (10%) there was stent fragmentation and in 9 (8.2%) stent migration. In 10 cases (9.1%), there was no change in the severity of the hydronephrosis, but because of flank pain or urinary tract infection with fever, the stents had to be removed. In 6 cases (5.4%) hydronephrosis developed or worsened after stenting. Of the 110 ureteral stents, 32.7% had to be removed because of late complications.Conclusions: Although ureteral stenting is undoubtedly an important procedure for the release of ureteral obstruction, the indications for stent insertion should be carefully considered in each patient. Late complications of ureteral stents are frequent and appear in one third of the patients. Close follow–up of stented patients is valuable in early detection of morbidity or complications, and in such cases the stent should be removed or exchanged as soon as possible.

1.
Zimskind PR, Fetter JR, Wilkerson JL: Clinical use of long–term indwelling silicone rubber ureteral splints inserted cystoscopically. J Urol 1967;97:840–844.
2.
Gibbons RP, Correa RJ Jr, Cummings KB, Mason JT: Experience with indwelling ureteral stent catheters. J Urol 1976;115:22–26.
3.
Finney RP: Experience with new double ureteral catheter stent. J Urol 1978;120:678– 681.
4.
Cardella JF, Castaneda–Zuniga WR, Hunter DW, Hulbert JC, Amplatz K: Urine–compatible polymer for long–term ureteral stenting. Radiology 1986;161:313–318.
5.
Pollard SG, Macfarlane R: Symptoms arising from double J ureteral stents. J Urol 1988; 139:37–38.
6.
Adams J: Renal stents. Emerg Med Clin North Am 1994;12:749–758.
7.
Monga M, Klein E, Castaneda–Zuniga WR, Thomas R: The forgotten indwelling ureteral stent: A urological dilemma. J Urol 1995;153: 1817–1821.
8.
Rembirink K, Goepel M, Meyer–Schwikerath M: The forgotten doube J stent: Case report of a multifractured ureteral stent. Urol Unt 1992;49:119–120.
9.
Zinsman A, Siegel YI, Siegmann A, Lindner A: Spontaneous ureteral stent fragmentation. J Urol 1995;153:718–721.
10.
Ellenbogen PH, Scheible FW, Talner LB, Leopold GR: Sensitivity of grey scale ultrasound in detecting urinary tract obstruction. A J 1978;130:731–733.
11.
Pocock RD, Stower MJ, Ferro MA, Smith PJ, Gingell JC: Double J stents: A review of 100 patients. Br J Urol 1986;58:629–633.
12.
Saltzman B: Ureteral stents: Indications, variations and complications. Urol Clin North Am 1988;15:481–491.
13.
El–Faqih SR, Shamsuddin AB, Chakrabarti A, Atassi R, Kardar AH, Osman MK, Husain I: Polyurethane internal ureteral stents in treatment of stone patients: Morbidity related to indwelling times. J Urol 1991;146:1487–1491.
14.
Persky L, Lockhart JJ, Karp R, Helal M, Hakki S: The overlooked retained double J stent. Urology 1990;36:519–521.
15.
Mosli HA, Farsi HM, Al–Zimaity MF, Salaeh TR, Al–Zamzami MM: Vesicoureteral reflux in patients with double pigtail stents. J Urol 1991;146:966–969.
16.
Bregg K, Riehle RA Jr: Morbidity associated with indwelling internal ureteral stents after shock wave lithotripsy. J Urol 1989;141:510– 512.
17.
El–Deen ME, Khalaf I, Rahim FA: Effect of internal ureteral stenting of normal ureter on the upper urinary tract: An experimental study. J Endourol 1993;7:399–405.
18.
Tschada R, Mickish G, Rassweiler J, Knebel L, Alken P: Success and failure with double J ureteral stent: Analysis of 107 cases. J Urol (Paris) 1991;97:93–97.
19.
Docimo SG, Dewolf WC: High failure rate of indwelling ureteral stents in patients with extrinsic obstruction: Experience at 2 institutions. J Urol 1989;142:277.
20.
Flückiger F, Lammer J, Klein GE: Malignant ureteral obstruction: Preliminary results of treatment with metallic self–expandable stents. Radiology 1993;186:169.
21.
Van Sonnenberg E, D’Agostino HB, O’Laoide R: Malignant ureteral obstruction: Treatment with metal stents – technique, results and observation with percutaneous intraluminal ureteral stents. Radiology 1994;191:765.
22.
Lang EK: Percutaneous management of ureteral strictures. Semin Intervent Radiol 1987; 4:79.
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