Retrospective Study of Patients with Forgotten Ureteral Double-J Stents in Aden, Yemen

Background: Double-J stents are among the basic and commonly used tools in urology.
Objective: To study the morbidity associated with forgotten ureteral stents and to describe the variables of the reason for prolonged indwelling time, complications and treatment
Materials and method: This is a retrospective observational study, which conducted in Aden, during the period January 2019 to December 2020. The records of all patients diagnosed with forgotten ureteral stents reviewed, and obtained the following data: sex, age, governorates, medical history, presenting complaints, total indwelling time of the stent, the reason for prolonged indwelling time, the x-ray, ultrasound investigations, complications and treatment.
Fisher test was used and p-value < 0.05 was considered as statistically significant. The statistical software package SPSS version 17 was used. 
Results: The study patients were 46 and they were 78.3% males and 21.7% females, (male:female ratio 3.6:1). The mean age of the patients was 35 ± 8.9 years, (range between 20 to 50 years). Patients of the age group < 40 years old were predominant 65.2%. Most of the patients were from rural governorates 89.1%. The mean duration of the indwelling stent in situ was 37.2 ± 13.2 months, and the duration ranged from 24 months to 60 months. 
Reasons for these long indwelling times were poor education of patient 37.0% and doctor did not inform the patient 37.0% followed by lack of awareness of patients 26.0%.
In the treatment procedures we found cystolithotripsy with ESWL was applied in 41.3% patients followed by ureterolithotripsy with ESWL in 37.0% patients, ESWL in 15.2% patients and PCNL in 6.5% patients.
The complications were stone formation 45.7% followed by the irritative lower urinary tract symptom 28.2%, renal failure 17.4% and urosepsis 8.7%.
Conclusion: Using double-J stents should be accompanied with a well education of the patient to reduce forgotten double-J stents and physicians need to be sensitized towards this health problem.

Keywords: Forgotten, ureteral double-J stents, Aden,