Double J stents have coiled ends to prevent migration, making them self-retaining. They are used short-term to relieve urinary tract obstruction, such as from a ureteric stone. Long-term use requires regular changes every 4–6 months. Prolonged retention can cause encrustation, stone formation, stent fracture, blockage (leading to hydronephrosis and renal impairment), and infections (recurrent UTIs or sepsis). Forgotten, encrusted stents—often due to poor patient compliance or inadequate counseling—pose a challenge, with no consensus on optimal treatment (endourological or open surgery may be required).

A case study of a 37-year-old woman with urosepsis and acute kidney injury due to a forgotten ureteric stent left in situ for three years. She initially has a ureteric stent inserted for an infected ureteric stone, she missed follow-up due to personal and logistic issues. Over two years, she had recurrent flank pain, but despite CT evidence of large bladder and intrarenal stones, no urology follow-up was arranged. This admission, she had E. coli septic shock. After IV antibiotics, laser lithotripsy was performed for the encrusted stent and stones (bladder, renal pelvis, PUJ). Post-op, she had a septic shower but improved with treatment. Unfortunately, she self-discharged on day six and failed to attend follow-up.

 

Rural patients often struggle with follow-up due to limited access to care, logistical challenges, and socioeconomic barriers. Enhancing patient education on stent complications and ensuring thorough pre- and post-insertion counselling are essential to reduce lost-to-follow-up rates—a key responsibility of treating physicians. This case illustrates the importance of developing robust follow-up mechanisms and patient education to ensure timely removal or replacement of ureteric stents, particularly in rural healthcare settings. Addressing these gaps can prevent long-term complications and improve outcomes.