Percutaneous antegrade removal of encrusted broken double J ureteric stent using a snare

Abstract

Percutaneous removal of partially encrusted broken double J ureteric stent from the renal pelvis using a snare is described. The patient is a 60-year old female, with a known case of hyperparathyroidism with double J ureteric stent placed one year earlier. Removal of the double J stent was attempted by cystoscopy but a loop of the stent was broken in the renal pelvis due to partial encrustation. Several unique aspects and technical challenges were encountered in this case including lack of pre-existing nephrostomy access in addition to a broken, partially encrusted stent which was near multiple renal stones and a newly-placed fully-functioning double J stent. The techniques to overcome those challenges are described. To the best of the author's knowledge, this is the first reported case of successful percutaneous removal of a broken encrusted double J stent by snare in the presence of such technical challenges.