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Removal of a stent remnant in the body - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Urinary and Bladder Problems
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3390 Questions
User :   hi
Doctor :   Hi
Doctor :   Dr xxxxx here
User :   hello doctor
Doctor :   how can i help u ?
User :   how long can a double J stent stay in the body
Doctor :   may i know what procedure have you undergone ?
User :   I had the stent because of a part of the ureter became small, so the urine back flows that caused hydronephrosis of the right kidney
Doctor :   so , you have Ureteral reflux
User :   and while i have the stent and already under gone ESWL
Doctor :   in that case, the stent is placed as long as there is obstruction to the flow of urine in the bladder ostia
User :   ok
User :   now what can cause the stent to become brittle
Doctor :   deposition of calcium salts etc can do that
User :   in 7 months can the stent be brittle? and what may happen if it becomes brittle?
Doctor :   do you know whether a synthetic stent is placed or a metallic stent has been placed
User :   synthetic
Doctor :   a synthetic stent, usually is made of silicone like material
Doctor :   and it will stay that way, without any issues
User :   the brand is BARD flouro-4 j-stent
User :   this is synthetic right?
Doctor :   yes
Doctor :   it is a silicone based stent
User :   ok are their cases that this kind of stent after 7 months breaks to pcs?
Doctor :   no
Doctor :   stents of polyurethene can have some issues
User :   and the name of my stent that i gave is this made of polyurethene?
Doctor :   no it is made of silicone
Doctor :   even in any case, i have not seen nay case of stent breakage , in either of the stents
User :   ok what can be the nearest possible explaination of when it was being removed the part that was inside the kidney was cut
Doctor :   when a stent is being removed, it can get cut by the instruments being used to remove it
Doctor :   that may be the only reason
User :   my stent was removed 2 days ago and bad news came that the portion where it is inside the kidney while the stent was being pulled was left behind
Doctor :   ok
Doctor :   so do u have any symptoms as of now ?
User :   when stents are being remove do doctors just pull them out? or they still have techniques that they use w/ help of instruments?
User :   while i was still in the recovery room i got chills
Doctor :   they use a cystoscope, that was initially used to put them into place at the time of the first procedure
Doctor :   that is fine , its due to the procedure itself
User :   and after they had put a drop light then i was transfered to my room
Doctor :   its a normal side effect seen due to any procedure on the urinary tract
User :   but when i entered the room the chills went back again more severe and temperature came to 40.1
Doctor :   yes, its due to urinary infection, which is common during any procedure involving cystoscopy
Doctor :   and it does subside within 24-48 hrs with treatment
Doctor :   that is not associated with the stent remnent left behind
Doctor :   did your doctor advice you anything or explain y that happened
User :   now i dont have fever anymore by my dizziness and feeling of wanting to vomit doesnt go away
Doctor :   it will stay for a few days
Doctor :   it is normal after such procedures
User :   he explained that it became brittle because i had it for 7 months
User :   but w/in that 7 months he let me underwent at the same time ESWL
Doctor :   ok
User :   i am more worried of the portion of the stent that was left inside my kidney
Doctor :   so if he left behind a fragment, did he tell how large the fragment it was, and which site it is located
Doctor :   usually if a stent is stuck within the muscular layer, there will be no issues as it is a inert substance and will not cause any issues
Doctor :   it will be just like sutures that are placed after a surgery
User :   no, not specifically. he just said that the portion where the loop end is the one that was left and that it was inside the kidney
Doctor :   ok
Doctor :   in that case, it is not going to cause any issues
Doctor :   since it may get covered by tissues
Doctor :   and just stay there
User :   but he said that after a month i need to undergo open surgery
Doctor :   why is that ?
Doctor :   do u have larger stones ?
User :   to remove the one that was left
User :   no more
Doctor :   you mean the stone , or the part of the stent ?
User :   no more stone only the left portion of the stent is inside the inner kidney
Doctor :   ok, so a larger part of the stent has been left behind , is this what your doctor say ?
User :   and he said that the left stent part can cause severe infection
User :   not very large part its only from where the curve of the stent starts
Doctor :   ok,
User :   something like this, do i really need to undergo open surgery?
Doctor :   it will depend on the site where the stent is lodged, if your doctor thinks that it can cause blockage in the urinary tract, it may be necessary to remove it
Doctor :   as blocked urinary tract can cause more complications
User :   he only said that the reason for the open surgery is for the prevention of severe infection
Doctor :   in that case, the surgery may be necessary
User :   ok what kind of surgery is the safest for this kind of removal?
User :   what may be the risk if i had open surgery?
Doctor :   here, what your doctor will do is open the abdomen near the flank
Doctor :   and then make an incision in the renal pelvis, and then remove the remnant of the stent that has been left there
Doctor :   this is a open surgery
User :   aside from this procedure are there any alternatives?
Doctor :   skin incision infections, a few days of hospital stay, nausea, bloating, urinary infections, are some side effects
Doctor :   if he choses and feels that it can be done a laparoscopic approach can be used as well
Doctor :   but that will depend on the doctors experience and skill
User :   having to open up the kidney can the kidney be damage or can the kidney fails?
Doctor :   no there is no risk of kidney failure
Doctor :   here the renal tissue is not cut,
Doctor :   it is the outlet of the kidney which is like a large pipe , is cut into
User :   but he said that he needs to open up the kidney itself
Doctor :   once it is sewn back , there will be no issues
Doctor :   yes the renal pelvis is considered part of the kidney
Doctor :   but if your doctor needs to cut the kidney, then some amount of bleeding, will be there
Doctor :   but this is controlled during surgery by hemostasis (prevention of bleeding)
User :   he is choosing between open surgery and percutaneous something
Doctor :   percutaneous is like laparoscopy
Doctor :   and has less side effects
Doctor :   but it depends on the doctors skill
User :   what kind of doctor should handle something like this is it still be a urologist or a nephrologists?
Doctor :   it is a urologist
Doctor :   urologist is a surgeon
Doctor :   nephrologist do not do surgeries , they manage medical conditions that can be managed without surgery
User :   oh now i understand their difference
Doctor :   ok.
User :   what may be the worst case scenario to anticipate?
Doctor :   in your case, it is just removal of a stent remnant
Doctor :   not a major one
Doctor :   but you may have urinary infections, and similar symptoms that you had this time around
User :   but the way he explains to us that this is a very big thing
Doctor :   as a surgeon he has to explain each and everything
User :   for something like this can you give me a rough estimate ofn how much would be
Doctor :   and as he knows the exact details of the case, he might know what exactly the issue is
Doctor :   what do u mean by estimate ? estimate of what ?
Doctor :   u mean the cost ?
User :   yes
Doctor :   It will depend on the hospital and the doctors charges, and both of them vary a lot
Doctor :   probably it may cost something around 5000 USD
User :   he gave me $7000
Doctor :   as i said , it does vary with place to place and hospital to hospital
Doctor :   the same surgery may cost 0000 USD, somewhere else
User :   yes i guess so,
Doctor :   the charges depend on the doctor
Doctor :   it is not uniform
User :   that is the most frustrating part if i knew that it will only be ending at having an open surgery i hope that i have it done from the very start not anymore go thru 4 session of ESWL
Doctor :   i understand and i am so sorry for you to be having going through this
Doctor :   i hope everything will work out fine
User :   yah me too. anyway thank you very much doctor for the explaination it help a lot
Doctor :   you are most welcome
Doctor :   thanks for consulting me here , please leave your valuable feedback
Doctor :   take care and have a good day.
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