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Knotted proximal loop of ureteric stents: Review of the literature and five case reports

The use of ureteric stents has become routine urological practice. Indications for insertion of ureteric stents include relieving ureteric obstruction,1 to promote ureteral healing following injury,2 prophylactically prior to extracorporeal shock wave lithotripsy (ESWL) or following complicated ureteroscopy3 to prevent ureteral obstruction, and to assist with ureteral identification during pelvic surgery.4 Placement of ureteric stents is associated with welldocumented complications including stent migration, encrustation, fragmentation and patients being lost to follow-up.3,5–7 Knot formation of ureteric stents is a rare complication with only 15 cases reported in the literature at the proximal end,8–22 two cases reported at the mid-portion of the ureteric stent23,24 and one case reported at the distal end.25 We present five cases of proximal stent knotting in one institution over a one-year period.