D J Stenting

DJ stent is double J stent/ retrograde ureteric stent. It is known as J stent as, the stent is curled from both the end, after its placement, so as to prevent it from dislodging. When the free flow of urine from the kidneys to the bladder, is obstructed due to some causes, and if this condition be ignored, can prove to be very harmful for the kidneys. So, to ensure the free smooth passage of the urine from kidneys to the bladder, the DJ stent is placed between the bladder to the kidney, by the urologists retro- grade approach or the interventional radiologists ante-grade approach.
Different gauges/ diameters of DJ uretery stents are available depending upon the varied sizes of the ureters. This treatment procedure is prefered over nephrostomy due to the internalization of the obstruction bypass.

Advantages:

  • Safer than Nephrostomy.
  • Minimal blood loss,
  • Minimum pain,
  • No blood transfusion.
  • Overnight hospital stay.
  • Utmost comfort to the patient.

Length Of The Surgery:

  • 3- 4 hours.

Causes:

  • Tumors in the uretery area.
  • Blocked kidney.
  • Scratched ureter during uteroscopy.

Diagnosis:

Percutaneous Nephrolithotomy is recommended after the following diagnosis tests.

  • Physical exam
  • Medical history.
  • X-ray.
  • CT scan.
  • MRI scan.
  • Cystoscopy.

Symptoms:

The short term or long term use of stents depends on certain indications as follows:

  • Malignant obstruction specially pelvis.
  • Benign strictures
  • Obstruction from urolithiasis
  • Retroperitoneal fibrosis.

Preparation:

Certain medications to be specifically avoided pre surgery:

  • Pre operative antibiotics.
  • Avoid wearing any jewelry.
  • Void the bladder regularly.
  • Avoid postop prophylactic antibiotics.

Procedure:

  • After examination and diagnosis, a double j stent of the approximate length of 24 to 30cm, is inserted through the ureters, up the bladder, all the way to the kidneys.
  • A cystoscope is used to place the stents.
  • After proper placement, the stent is prevented from moving out of place, by coiling it at both the ends.

Risks:

The PCNL potential risks include:

  • Flank pain.
  • Migration/ dislodging of the stent.
  • Urosepsis.
  • Impassable stricture.
  • Difficult/ painful urination.
  • Blood-tinged urine.
  • Infection.
  • Dislocation.
  • Blockage by encrustation.

Follow- up:

It’s usually recommended that someone stays with you for the first 24 hours after surgery. This is in case you experience any symptoms that suggest there could be a problem, such as:

  • 24 hour surveillance.
  • Drink 8 to 10 glasses of water.
  • Empty bladder regularly.
  • Do not suppress the sensation to urinate.
  • Avoid torso movement.
  • Avoid aerobics.

Visit doctor:

  • Removal of cathedral/ urinary stent/ spirometry device 2 3 weeks after surgery.
  • Developed Hematuria/ UTI.
  • Difficult/ painful voiding and fully emptying the bladder.

All above, treatments are finalized taking into consideration the overall health, severity, age and other ailments of the patient. Only a well experienced urologist should perform the above treatment.