DJ stent otherwise called Double ‘J’ stent in one of the most commonly performed procedure in urology practice. Indications of DJ stenting are innumerable and some of most common include kidney stone surgery. Once placed in kidney, it need to be removed after its due purpose of placement has been achieved, which is generally 3-4 weeks after kidney stone surgery. Long duration of DJ stent can lead to infectious complications. If prolonged duration of DJ stent is required, it need to be replaced with fresh one at appropriate time interval.
Preaenting here is a patient who had kidney stones and operated elsewhere facility, where RIRS was done. Following RIRS, he had few small residual stones left and DJ stent was placed. It was left indwelling for more than 6 months. Patient started getting febrile UTI symptoms with passage of white flaky materials in urine. He was managed initially with iv antibiotics to which he partially responded. Subsequently patient visited our healthcare centre and evaluated for his symptoms. He was planned for DJ stent removal and residual stone removal once symptomatically improved.
Upon cystoscopy, the stent was heavily contaminated with fungal (candida) growth, the reason for his passage of whitish flakes in urine. The stent was removed and his residual stones were cleared. Oral antifungal with oral antibiotics were given and subsequently patient never suffered from any urinary infections.
In summary, long indwelling DJ stent in kidney predispose the development of recurrent UTI due to bacterial or fungal contamination over stent, which sometimes can be very serious and life threatening. Timed removal or replacement is must to avoid such complications.
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