Ureteral strictures can cause significant morbidity and are often managed with balloon dilation, endoureterotomy, or surgical repair. The Allium ureteral stent, a self-expanding large-caliber stent, offers a minimally invasive alternative, designed to maintain ureteral patency while resisting encrustation and migration. However, stent migration remains a recognized complication.

 

Case presentation We report the case of a 53-year-old woman with a right ureteral stricture and a history of recurrent stent dislodgement. She underwent successful Allium stent placement in March 2024, with initial symptom relief and confirmed patency on follow-up imaging. Ten months later, she was presented with acute right flank pain, hematuria, and hydronephrosis. Imaging revealed upward migration of the stent and recurrent obstruction. Endoscopic evaluation identified a stricture with mucosal changes and a proximally migrated Allium stent. Under general anesthesia and fluoroscopic guidance, the stent was successfully repositioned distal to the stricture using a cystoscope grasper. Post-procedure imaging confirmed ureteral patency. The patient experienced resolution of pain and hematuria, and renal function normalized. She was discharged in stable condition the following day.

This case highlights a rare complication of delayed Allium stent migration. Fluoroscopy-guided endoscopic repositioning proved effective, obviating the need for stent replacement or open surgery. Close imaging follow-up and early intervention are essential to detect and manage migration-related complications.