The Use of Extracorporeal Shock Wave Lithotripsy to Manage a Knotted Ureteric Stent: A Case Report

This case report describes the successful management of a knotted ureteric stent in a 57-year-old male with diabetes mellitus, who presented with left flank pain and lower urinary tract symptoms after seven months of stent placement. Initial imaging revealed migration and encrustation of the stent, along with knotting at the proximal end. As rigid cystoscopy to attempt stent retrieval met resistance, a semirigid ureteroscope was used to laser transect the stent, allowing for the insertion of a new stent. Following this, extracorporeal shock wave lithotripsy was performed to target the knotted portion, successfully facilitating its unknotted migration. Final imaging confirmed the appropriate positioning of both stents, enabling their subsequent removal without complications. This case underscores an effective, innovative approach to managing complex ureteric stent complications.