Strategy to track double-J stents placed during COVID-19 using smartphone-based stent tracker application to prevent forgotten double-J stent in a high-volume centre: a smart solution

Abhirudra Mulay1, Rohit Kapoor1, Shivesh Sharma1, Shashikant Asabe1, Hareesh Belagali1, Siddharth Singh1, Vikram Satav1, Vilas Sabale1
1Department of Urology, Dr. D. Y. Patil Medical College and Research Centre, Renal Transplantation and Robotic Surgery, Pimpri-Chinchwad, 411018, India

Tóm tắt

Abstract Background Forgotten or retained (double-J) DJ stents may lead to several complications. Management of retained DJ stents poses a challenge for urologists not just surgically but also medicolegally and adds to the economic burden of the patient. Difficulty in follow-up for patients due to the contagious nature of COVID-19 and several restrictions posed in the form of lockdown. Smartphones today have become an integral part of our daily lives providing a convenient and reliable platform for data storage and access. Methods All patients requiring placement of DJ stents and agreeing to enrol in the study were registered on the application over the physicians smartphone. SMSs regarding dates for removal of stent and follow-up with the literature regarding stent care were sent to the patients in their regional language. Results A total of 100 patients were stented during this period of 3 months. Mean age was 42.61 years with three patients of paediatric age group. Mean duration of stent was 6 weeks. All patients received periodic messages (average 3) regarding follow-up and date for stent removal. 3%(n = 3) patients were delayed for follow-up; 2% (n = 2) patients lost to follow-up, compared to a 9% to 10% loss to follow-up in patients followed up only on paper discharges in our department previously. Conclusion It significantly reduced the number of physical visits of the patient to the hospital and provided a more streamlined tracking of the indwelling stents for the user; patient compliance was found to be almost 98%; being cloud based (android/iOS), it was easily accessible to the user; and with the option of sharing the account details, the patient record could be accessed by several residents from their individual devices, which significantly reduced loss to follow-up rates from 9 to 2%.

Từ khóa


Tài liệu tham khảo

Lange D, Bidnur S, Hoag N, Chew BH (2015) Ureteral stent-associated complications–where we are and where we are going. Nat Rev Urol 12(1):17–25

Kawahara T, Ito H, Terao H, Yoshida M, Matsuzaki J (2012) Ureteral stent encrustation, incrustation, and coloring: morbidity related to indwelling times. J Endourol 26(2):178–82

Singh V, Srinivastava A, Kapoor R, Kumar A (2005) Can the complicated forgotten indwelling ureteric stents be lethal? Int Urol Nephrol 37(3):541–546

Divakaruni N, Palmer CJ, Tek P, Bjurlin MA, Gage MK, Robinson J, Lombardo L, Wille MA, Hollowell CM (2013) Forgotten ureteral stents: who’s at risk? J Endourol 27(8):1051–1054

Monga M, Klein E, Castañeda-Zúñiga WR, Thomas R (1995) The forgotten indwelling ureteral stent: A urological dilemma. J Urol 153:1817–1819

McCahy PJ, Ramsden PD (1996) A computerized ureteric stent retrieval system. Br J Urol 77:147–148

Ather MH, Talati J, Biyabani R (2000) Physician responsibility for removal of implants: the case for a computerized program for tracking overdue double-J stents. Tech Urol 6(3):189–192

Sabharwal S, Macaden AR, Abrol N, Mukha RP, Kekre NS (2014) A novel computer based stent registry to prevent retained stents: Will patient directed automated short message service and letter generator help? Indian J Urol 30(2):150–152

Molina WR, Pessoa R, Donalisio da Silva R, Kenny MC, Gustafson D, Nogueira L et al (2017) A new patient safety smartphone application for prevention of “forgotten” ureteral stents: results from a clinical pilot study in 194 patients. Patient Saf Surg. 11:10

Ziemba JB, Ludwig WW, Ruiz L, Carvalhal E, Matlaga BR (2017) Preventing the forgotten ureteral stent by using a mobile point-of-care application. J Endourol 31(7):719–724

Ulker V, Atalay HA, Cakmak O, Yucel C, Celik O, Kozacioglu Z (2019) Smartphone-based stent tracking application for prevention of forgotten ureteral double-J stents: a prospective study. Int Braz J Urol 45(2):376–383. https://doi.org/10.1590/S1677-5538.IBJU.2018.0707

Sancaktutar AA, Tepeler A, Söylemez H, Penbegül N, Atar M, Bozkurt Y et al (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(3):253–258