尿管ステントの合併症

「1 尿管ステント関連症状(ureteral stent related symptoms)」「症状」尿路ステント留置による症状として頻度の高い症状は頻尿, 尿意切迫感, 排尿痛, 残尿感, 排尿困難感といった下部尿路症状や側腹部・下腹部痛, 血尿などがあり, これらを尿管ステント関連症状という. 「頻度」ステントを留置された80%以上の症例で認められると報告されており, 尿管ステント留置後に患者のQOLを低下させる最も重要な要因である. 「評価」尿路ステント関連症状の評価には International Prostate Symptoms Score (IPSS)/QOL score や v...

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Published inJapanese Journal of Endourology Vol. 31; no. 2; pp. 201 - 206
Main Author 松崎, 純一
Format Journal Article
LanguageJapanese
Published 日本泌尿器内視鏡学会 01.09.2018
Online AccessGet full text
ISSN2186-1889
2187-4700
DOI10.11302/jsejje.31.201

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Abstract 「1 尿管ステント関連症状(ureteral stent related symptoms)」「症状」尿路ステント留置による症状として頻度の高い症状は頻尿, 尿意切迫感, 排尿痛, 残尿感, 排尿困難感といった下部尿路症状や側腹部・下腹部痛, 血尿などがあり, これらを尿管ステント関連症状という. 「頻度」ステントを留置された80%以上の症例で認められると報告されており, 尿管ステント留置後に患者のQOLを低下させる最も重要な要因である. 「評価」尿路ステント関連症状の評価には International Prostate Symptoms Score (IPSS)/QOL score や visual analogue pain scale (VAPS)で行われていたが, 2001年に提唱された Ureteral Stent Symptoms Questionnaire (USSQ)が尿管ステントを留置した際の症状や患者のQOLを評価するのに有用である. 現在, 日本泌尿器内視鏡学会尿路ステント部会にて日本語版を作成中である.
AbstractList 「1 尿管ステント関連症状(ureteral stent related symptoms)」「症状」尿路ステント留置による症状として頻度の高い症状は頻尿, 尿意切迫感, 排尿痛, 残尿感, 排尿困難感といった下部尿路症状や側腹部・下腹部痛, 血尿などがあり, これらを尿管ステント関連症状という. 「頻度」ステントを留置された80%以上の症例で認められると報告されており, 尿管ステント留置後に患者のQOLを低下させる最も重要な要因である. 「評価」尿路ステント関連症状の評価には International Prostate Symptoms Score (IPSS)/QOL score や visual analogue pain scale (VAPS)で行われていたが, 2001年に提唱された Ureteral Stent Symptoms Questionnaire (USSQ)が尿管ステントを留置した際の症状や患者のQOLを評価するのに有用である. 現在, 日本泌尿器内視鏡学会尿路ステント部会にて日本語版を作成中である.
Author 松崎, 純一
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References 51) Kondo N (2005) A case demonstrating knot formation at the upper end of a ureteral stent. Hinyokika Kiyo 51 : 385-387
1) Joshi HB, Okeke A, Newns N, et al. (2002) Characterization of urinary symptoms in patients with ureteral stents. Urology 59 : 511-519
42) Saltzman B (1988) Ureteral stents. Indications, variations, and complications. Urol Clin North Am 115 : 481-491
5) Miyaoka R, Monga M (2009) Ureteral stent discomfort : Etiology and management. Indian J Urol 25 : 455-460
10) Robert M (1997) Double-J ureteric stent encrustations : clinical study on crystal formation on polyurethane stents. Urol Int 58 : 100-104
16) Monga M (1995) The forgotten indwelling ureteral stent : a urological dilemma. J Urol 153 : 1817-1819
8) Kawahara T, Ito H. Terao H, et al. (2012) Choosing an appropriate length of loop type ureteral stent using direct ureteral length measurement. Urol Int 88 : 48-53.
27) Agarwal MM (2009) Endourologic management of forgotten encrusted ureteral stents : can ureteroscopic lithotripsy be avoided? Surg Laparosc Endosc Percutan Tech 19 : 72-77
55) Richards MM (2011) Successful treatment of stent knot in the proximal ureter using ureteroscopy and holmium laser. Case Rep Med 2011 : 502191. doi : 10.1155/2011/502191. Epub 2011 May 10.
52) 厚生労働省医薬食品局通達, 薬食審査発第0201001号 : 平成17年2月1日
37) Wall I (2008) Spontaneous perforation of the duodenum by a migrated ureteral stent. Gastrointest Endosc 68 : 1236-1238
6) Ho CH, Chen SC, Chung SD, et al. (2008) Determining the Apropriate Length of a Double-Pigtail Ureteral Stent by Both Stent Configurations and Related Symptoms. J Endourol 22 : 1427-1431
7) Giannarini G, Keeley FX Jr, Valent F, et al. (2011) Predictors of morbidity in patients with indwelling ureteric stents : results of a prospective study using the validated Ureteric Stent Symptoms Questionnaire. BJU Int 107 : 648-654
18) Bukkapatnam R (2003) 1-step removal of encrusted retained ureteral stents. J Urol 170 : 1111-1114
28) Lam JS (2002) Tips and tricks for the management of retained ureteral stents. J Endourol 16 : 733-741
11) Mohan-Pillai K (1999) Endourological management of severely encrusted ureteral stents. J Endourol 13 : 377-379
50) Basavaraj DR (2007) Case report : Knotted ureteral stent in patient with ileal conduit : Conservative approach for retrieval. J Endourol 21 : 90-93
19) Kawahara T (2012) Encrusted Ureteral Stent Retrieval Using Flexible Ureteroscopy with a Ho : YAG Laser. Case Rep Med 2012 : 862539
12) Wollin TA (1998) Bacterial biofilm formation, encrustation, and antibiotic adsorption to ureteral stents indwelling in humans. J Endourol 12 : 101-111
17) Singh V (2005) Can the complicated forgotten indwelling ureteric stents be lethal? Int Urol Nephrol 37 : 541-546
36) Ioannis C (2003) Retrovesical migration of malpositioned double-j ureteral stent. Int Urol Nephrol 35 : 325-326
48) Karagüzel E (2012) Knotted ureteral stent : a rare complication of ureteral stent usage. Urol Res 40 : 793-795
44) Yap RL (2004) Retrieval of migrated ureteral stent by intussusception of ureteral balloon dilator tip. Urology 63 : 571-573
26) Bultitude MF (2003) Management of encrusted ureteral stents impacted in upper tract. Urology 62 : 622-626
53) Sighinolfi MC (2004) A knotted multi-length ureteral stent : a rare complication. Urol Res 2005 Feb ; 33 (1) : 70-71
38) Billoud E (2008) Double J ureteral stent as an unusual endoscopic finding in a patient with rectal bleeding. Gastrointest Endosc 68 : 1239-1240
30) Ather MH (2000) Physician responsibility for removal of implants : the case for a computerized program for tracking overdue double-J stents. Tech Urol 6 : 189-192
29) Bostanci Y (2012) Single session removal of forgotten encrusted ureteral stents : combined endourological approach. Urol Res 40 : 523-529
39) Falahatkar S (2012) Intracaval migration : an uncommon complication of ureteral Double-J stent placement. J Endourol 26 : 119-121
54) Flam TA (1995) Knotting of a double pigtail stent within the ureter : an initial report. J Urol 154 : 1858-1859
33) Slaton JW (1996) Proximal ureteral stent migration : an avoidable complication? J Urol 155 (1) : 58-61
9) Kawahara T, Ito H, Terao H, et al. (2012) Ureteral stent encrustation, incrustation, and coloring : morbidity related to indwelling times. J Endourol 26 : 178-182
41) LeRoy AJ (1986) Indwelling ureteral stents : percutaneous management of complications. Radiology 158 : 219-222
45) Niendorf DC (1975) Retrieval of indwelling ureteral stent utilizing Fogarty catheter. Urology 6 : 622-623
35) Damiano R (2002) Early and late complications of double pigtail ureteral stent. Urol Int 69 : 136-140
13) Keane PF (1994) Characterization of biofilm and encrustation on ureteric stents in vivo. Br J Urol 73 : 687-691
14) Tunney MM (1997) Assessment of urinary tract biomaterial encrustation using a modified Robbins device continuous flow model. J Biomed Mater Res 38 : 87-93
49) Quek ML (2002) Knot formation at the mid portion of an indwelling ureteral stent. J Urol. 168 : 1497.
21) Teichman JM (1997) Total endoscopic management of the encrusted ureteral stent under a single anaesthesia. Can J Urol 4 : 456-459
43) Livadas KE (2007) Ureteroscopic removal of mildly migrated stents using local anesthesia only. J Urol 178 : 1998-2001
3) Joshi HB, Newns N, Stainthorpe A, et al. (2003) Ureteral stent symptom questionnaire : development and validation of a multidimensional quality of life measure. J Urol 169 : 1060-1064
20) Weedin JW (2011) The impact of proximal stone burden on the management of encrusted and retained ureteral stents. J Urol 185 : 542-547
24) Yeh CC (2004) A new technique for treating forgotten indwelling ureteral stents : silk loop assisted ureterorenoscopic lithotripsy. J Urol 171 : 719-721
22) Aravantinos E (2006) Forgotten, encrusted ureteral stents : a challenging problem with an endourologic solution. J Endourol 20 : 1045-1049
47) Ho CH (2009) Retrieval of a misplaced double-J ureteral stent in the renal pelvis : a novel technique. Surg Laparosc Endosc Percutan Tech 19 : e24-5. doi : 10.1097/SLE.0b013e318196c91a.
25) Singh I (2001) Severely encrusted polyurethane ureteral stents : management and analysis of potential risk factors. Urology 58 : 526-531
34) Breau RH (2001) Optimal prevention and management of proximal ureteral stent migration and remigration. J Urol 166 : 890-893
46) Nagele U (2006) Comparison of flexible grasping forceps and stone basket for removal of retracted ureteral stents. J Endourol 20 : 418-422
32) Sancaktutar AA (2012) A solution for medical and legal problems arising from forgotten ureteral stents : initial results from a reminder short message service (SMS). Urol Res 40 : 253-258
23) Vanderbrink BA (2008) Encrusted urinary stents : evaluation and endourologic management. J Endourol 22 : 905-912
31) Tang VC (2008) Ureteric stent card register - a 5-year retrospective analysis. Ann R Coll Surg Engl 90 : 156-159
56) Braslis KG (1992) Spontaneous knotting of a pigtail ureteric stent in the ureter requiring percutaneous removal. Aust N Z J Surg 62 : 825-826
4) Joshi HB, Stainthorpe A, Keeley FX, et al. (2001) Indwelling Ureteral Stents : Evaluation of Quality of Life to Aid Outcome Analysis. J Endourol 15 : 151-154
40) Michalopoulos AS (2002) Acute postoperative pulmonary thromboembolism as a result of intravascular migration of a pigtail ureteral stent. Anesth Analg 95 : 1185-1188
2) Byrne RR, Auge BK, Kourambas J, et al. (2002) Routine ureteral stenting is not necessary after ureteroscopy and ureteropyeloscopy : a randomized trial. J Endourol 16 : 9-13
15) Desgrandchamps F (1997) An in vitro comparison of urease-induced encrustation of JJ stents in human urine. Br J Urol 79 : 24-27
References_xml – reference: 49) Quek ML (2002) Knot formation at the mid portion of an indwelling ureteral stent. J Urol. 168 : 1497.
– reference: 29) Bostanci Y (2012) Single session removal of forgotten encrusted ureteral stents : combined endourological approach. Urol Res 40 : 523-529
– reference: 17) Singh V (2005) Can the complicated forgotten indwelling ureteric stents be lethal? Int Urol Nephrol 37 : 541-546
– reference: 52) 厚生労働省医薬食品局通達, 薬食審査発第0201001号 : 平成17年2月1日
– reference: 40) Michalopoulos AS (2002) Acute postoperative pulmonary thromboembolism as a result of intravascular migration of a pigtail ureteral stent. Anesth Analg 95 : 1185-1188
– reference: 7) Giannarini G, Keeley FX Jr, Valent F, et al. (2011) Predictors of morbidity in patients with indwelling ureteric stents : results of a prospective study using the validated Ureteric Stent Symptoms Questionnaire. BJU Int 107 : 648-654
– reference: 13) Keane PF (1994) Characterization of biofilm and encrustation on ureteric stents in vivo. Br J Urol 73 : 687-691
– reference: 43) Livadas KE (2007) Ureteroscopic removal of mildly migrated stents using local anesthesia only. J Urol 178 : 1998-2001
– reference: 2) Byrne RR, Auge BK, Kourambas J, et al. (2002) Routine ureteral stenting is not necessary after ureteroscopy and ureteropyeloscopy : a randomized trial. J Endourol 16 : 9-13
– reference: 5) Miyaoka R, Monga M (2009) Ureteral stent discomfort : Etiology and management. Indian J Urol 25 : 455-460
– reference: 31) Tang VC (2008) Ureteric stent card register - a 5-year retrospective analysis. Ann R Coll Surg Engl 90 : 156-159
– reference: 10) Robert M (1997) Double-J ureteric stent encrustations : clinical study on crystal formation on polyurethane stents. Urol Int 58 : 100-104
– reference: 38) Billoud E (2008) Double J ureteral stent as an unusual endoscopic finding in a patient with rectal bleeding. Gastrointest Endosc 68 : 1239-1240
– reference: 53) Sighinolfi MC (2004) A knotted multi-length ureteral stent : a rare complication. Urol Res 2005 Feb ; 33 (1) : 70-71
– reference: 18) Bukkapatnam R (2003) 1-step removal of encrusted retained ureteral stents. J Urol 170 : 1111-1114
– reference: 23) Vanderbrink BA (2008) Encrusted urinary stents : evaluation and endourologic management. J Endourol 22 : 905-912
– reference: 15) Desgrandchamps F (1997) An in vitro comparison of urease-induced encrustation of JJ stents in human urine. Br J Urol 79 : 24-27
– reference: 30) Ather MH (2000) Physician responsibility for removal of implants : the case for a computerized program for tracking overdue double-J stents. Tech Urol 6 : 189-192
– reference: 54) Flam TA (1995) Knotting of a double pigtail stent within the ureter : an initial report. J Urol 154 : 1858-1859
– reference: 27) Agarwal MM (2009) Endourologic management of forgotten encrusted ureteral stents : can ureteroscopic lithotripsy be avoided? Surg Laparosc Endosc Percutan Tech 19 : 72-77
– reference: 6) Ho CH, Chen SC, Chung SD, et al. (2008) Determining the Apropriate Length of a Double-Pigtail Ureteral Stent by Both Stent Configurations and Related Symptoms. J Endourol 22 : 1427-1431
– reference: 36) Ioannis C (2003) Retrovesical migration of malpositioned double-j ureteral stent. Int Urol Nephrol 35 : 325-326
– reference: 47) Ho CH (2009) Retrieval of a misplaced double-J ureteral stent in the renal pelvis : a novel technique. Surg Laparosc Endosc Percutan Tech 19 : e24-5. doi : 10.1097/SLE.0b013e318196c91a.
– reference: 16) Monga M (1995) The forgotten indwelling ureteral stent : a urological dilemma. J Urol 153 : 1817-1819
– reference: 22) Aravantinos E (2006) Forgotten, encrusted ureteral stents : a challenging problem with an endourologic solution. J Endourol 20 : 1045-1049
– reference: 32) Sancaktutar AA (2012) A solution for medical and legal problems arising from forgotten ureteral stents : initial results from a reminder short message service (SMS). Urol Res 40 : 253-258
– reference: 19) Kawahara T (2012) Encrusted Ureteral Stent Retrieval Using Flexible Ureteroscopy with a Ho : YAG Laser. Case Rep Med 2012 : 862539
– reference: 50) Basavaraj DR (2007) Case report : Knotted ureteral stent in patient with ileal conduit : Conservative approach for retrieval. J Endourol 21 : 90-93
– reference: 12) Wollin TA (1998) Bacterial biofilm formation, encrustation, and antibiotic adsorption to ureteral stents indwelling in humans. J Endourol 12 : 101-111
– reference: 3) Joshi HB, Newns N, Stainthorpe A, et al. (2003) Ureteral stent symptom questionnaire : development and validation of a multidimensional quality of life measure. J Urol 169 : 1060-1064
– reference: 56) Braslis KG (1992) Spontaneous knotting of a pigtail ureteric stent in the ureter requiring percutaneous removal. Aust N Z J Surg 62 : 825-826
– reference: 9) Kawahara T, Ito H, Terao H, et al. (2012) Ureteral stent encrustation, incrustation, and coloring : morbidity related to indwelling times. J Endourol 26 : 178-182
– reference: 42) Saltzman B (1988) Ureteral stents. Indications, variations, and complications. Urol Clin North Am 115 : 481-491
– reference: 24) Yeh CC (2004) A new technique for treating forgotten indwelling ureteral stents : silk loop assisted ureterorenoscopic lithotripsy. J Urol 171 : 719-721
– reference: 20) Weedin JW (2011) The impact of proximal stone burden on the management of encrusted and retained ureteral stents. J Urol 185 : 542-547
– reference: 48) Karagüzel E (2012) Knotted ureteral stent : a rare complication of ureteral stent usage. Urol Res 40 : 793-795
– reference: 21) Teichman JM (1997) Total endoscopic management of the encrusted ureteral stent under a single anaesthesia. Can J Urol 4 : 456-459
– reference: 28) Lam JS (2002) Tips and tricks for the management of retained ureteral stents. J Endourol 16 : 733-741
– reference: 1) Joshi HB, Okeke A, Newns N, et al. (2002) Characterization of urinary symptoms in patients with ureteral stents. Urology 59 : 511-519
– reference: 55) Richards MM (2011) Successful treatment of stent knot in the proximal ureter using ureteroscopy and holmium laser. Case Rep Med 2011 : 502191. doi : 10.1155/2011/502191. Epub 2011 May 10.
– reference: 41) LeRoy AJ (1986) Indwelling ureteral stents : percutaneous management of complications. Radiology 158 : 219-222
– reference: 14) Tunney MM (1997) Assessment of urinary tract biomaterial encrustation using a modified Robbins device continuous flow model. J Biomed Mater Res 38 : 87-93
– reference: 33) Slaton JW (1996) Proximal ureteral stent migration : an avoidable complication? J Urol 155 (1) : 58-61
– reference: 37) Wall I (2008) Spontaneous perforation of the duodenum by a migrated ureteral stent. Gastrointest Endosc 68 : 1236-1238
– reference: 51) Kondo N (2005) A case demonstrating knot formation at the upper end of a ureteral stent. Hinyokika Kiyo 51 : 385-387
– reference: 26) Bultitude MF (2003) Management of encrusted ureteral stents impacted in upper tract. Urology 62 : 622-626
– reference: 11) Mohan-Pillai K (1999) Endourological management of severely encrusted ureteral stents. J Endourol 13 : 377-379
– reference: 45) Niendorf DC (1975) Retrieval of indwelling ureteral stent utilizing Fogarty catheter. Urology 6 : 622-623
– reference: 4) Joshi HB, Stainthorpe A, Keeley FX, et al. (2001) Indwelling Ureteral Stents : Evaluation of Quality of Life to Aid Outcome Analysis. J Endourol 15 : 151-154
– reference: 34) Breau RH (2001) Optimal prevention and management of proximal ureteral stent migration and remigration. J Urol 166 : 890-893
– reference: 25) Singh I (2001) Severely encrusted polyurethane ureteral stents : management and analysis of potential risk factors. Urology 58 : 526-531
– reference: 35) Damiano R (2002) Early and late complications of double pigtail ureteral stent. Urol Int 69 : 136-140
– reference: 39) Falahatkar S (2012) Intracaval migration : an uncommon complication of ureteral Double-J stent placement. J Endourol 26 : 119-121
– reference: 8) Kawahara T, Ito H. Terao H, et al. (2012) Choosing an appropriate length of loop type ureteral stent using direct ureteral length measurement. Urol Int 88 : 48-53.
– reference: 44) Yap RL (2004) Retrieval of migrated ureteral stent by intussusception of ureteral balloon dilator tip. Urology 63 : 571-573
– reference: 46) Nagele U (2006) Comparison of flexible grasping forceps and stone basket for removal of retracted ureteral stents. J Endourol 20 : 418-422
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Title 尿管ステントの合併症
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