2025/12/31 by SHINWARI, SAJJAD MUHAMMAD KHAN
#Forgotten DJ stents ureteral stents encrustation urological complications low-resource settings Pakistan. #Medical Specialties #Medicine and Health Sciences #Urology
paper · doi:10.17605/osf.io/enh78
This research project investigates the clinical burden, preventable complications, and underlying causes associated with forgotten double-J (DJ) ureteral stents in a tertiary care hospital in Pakistan. DJ stents are routinely placed to relieve ureteric obstruction, but their failure to be removed on time can lead to serious morbidity. In many low-resource settings, lapses in follow-up, low patient awareness, and financial or systemic barriers contribute to prolonged stent retention. The purpose of this project is to quantify how frequently these stents are forgotten, identify the extent and severity of resulting complications, and determine the patient- and system-level factors that predict adverse outcomes. The study uses a retrospective observational design, examining data from May 2023 to April 2025. All included patients had retained DJ stents for more than three months beyond their advised removal date without valid clinical justification. Demographic characteristics, socioeconomic status, clinical presentation, stent dwell time, and reasons for delayed removal were documented. Complications such as encrustation, fragmentation, stone formation, and migration were assessed, and all required interventions were recorded. Statistical analyses, including logistic regression and Spearman’s correlation, were performed to identify predictors of stent encrustation and to quantify the relationship between the duration of stent retention and complication severity. The expected outcomes of this project include a clearer understanding of the risk profile associated with forgotten DJ stents and an evidence-based identification of factors that significantly increase the likelihood of complications. Preliminary findings show that over one-third of patients retained stents beyond six months, with unawareness and financial limitations being leading causes. Encrustation was the most common complication, and low educational status along with stent retention longer than six months were independent predictors of severe encrustation. In extreme cases, complex interventions or even nephrectomy were required, underscoring the severity of preventable harm. The broader goal of the research is to inform clinical practice and public health strategies. By highlighting the consequences of forgotten stents and identifying vulnerable patient groups, the project aims to support the development of systematic tracking protocols, automated reminder systems, improved follow-up mechanisms, and community-level awareness programmes. Ultimately, the research seeks to reduce preventable urological morbidity, lessen financial and procedural burdens on healthcare systems, and improve patient safety in low- and middle-income settings.