Indian Journal of Urology
LETTER TO EDITOR
Year
: 2014  |  Volume : 30  |  Issue : 4  |  Page : 457--458

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


Jayesh Modi, Ramya Nagarajan, Suresh Kumar 
 Department of Urology and Renal Transplantation, Smt. Gulabben Rasiklal Doshi and Smt. Kamlaben Mafatlal Mehta Institute of Kidney Diseases and Research Centre and Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat, India

Correspondence Address:
Jayesh Modi
2, Kamdhenu Apt., Behind St Xaviers Loyolla Hall School, Memnagar, Ahmedabad 380 052
India




How to cite this article:
Modi J, Nagarajan R, Kumar S. Re: Sabharwal S, Macaden AR, Abrol N, Mukha RP, Kekre NS. A novel computer based stent registry to prevent retained stents: Will patient directed automated short message service and letter generator help? Indian J Urol 2014;30:150-2 .Indian J Urol 2014;30:457-458


How to cite this URL:
Modi J, Nagarajan R, Kumar S. Re: Sabharwal S, Macaden AR, Abrol N, Mukha RP, Kekre NS. A novel computer based stent registry to prevent retained stents: Will patient directed automated short message service and letter generator help? Indian J Urol 2014;30:150-2 . Indian J Urol [serial online] 2014 [cited 2020 Apr 1 ];30:457-458
Available from: http://www.indianjurol.com/text.asp?2014/30/4/457/142082


Full Text

Dear Editor,

We have read the original article titled "A novel computer based stent registry to prevent retained stents: Will patient directed automated short message service and letter generator help?" by Sabharwal et al., with great interest. [1] Forgotten stents produce encrustations and stones, which may require either a retrograde or antegrade approach to remove them. Most importantly, these can be prevented by taking certain precautions. We would like to congratulate the authors for applying a novel computer-based stent registry to minimize this issue, especially in a big country like India.

However, certain problems may occur during this patient-directed automated information system. The targeted population for this novel registry mainly resides in villages. Frequent change of mobile numbers, network connectivity issues, or inadequate balance in the SIM-card can make this population difficult to reach. Additionally, short message service (SMS) generated in English language may not be that useful for people knowing only regional languages.

Lack of documentation and patient's unawareness about the presence of stent were the common reasons for retained stents as mentioned by authors in their 10-year retrospective study. [1] We believe that one important cause of forgotten stents is inadequate explanation to the patient at the time of discharge by the house officers/junior resident doctors as they write up the discharge summary with explanations for further follow-up. We suggest certain simple but effective means to combat these pitfalls.

As visual impressions have a lasting impact on memory, it is the practice at our institute to get an X-ray KUB postoperatively and show the images of the stent to the patient (after removal of other tubes/catheters), stressing that he/she needs to get it removed. Second, as most patients requiring stent insertion usually have urolithiasis, we send a specimen of the calculus for structural and morphological stone analysis. The patient is told that he will have to pay us a second visit, at which time his stent would be removed, and strategies for preventing stone formation can be planned based on the results of the stone analysis. This review date is calculated in advance and written in the discharge summary. Third, involving the local doctor (or referring physician) into the whole process with a phone call/letter would help, as he or his family members would often visit the family physician for primary care, enabling us to trace the patient easily.

We like the authors' idea of sending letters, and the advantage is that it can be written in the regional language, and it is unusual that people change their permanent address frequently. Postal mail is still frequently used in our country despite technological advances such as email and mobile messaging. However, technology is changing very fast, and we should certainly use it to our advantage in health care delivery, as proposed by the authors. We conclude that by adding certain simple measures mentioned above to the novel computer-based stent registry we can make it even more effective to decrease the incidence of retained "double J" stents.

References

1Sabharwal S, Macaden AR, Abrol N, Mukha RP, Kekre NS. A novel computer based stent registry to prevent retained stents: Will patient directed automated short message service and letter generator help? Indian J Urol 2014;30:150-2.