DOI: https://doi.org/10.36347/sjmcr.2026.v14i04.053

Pages: 810-812

Background: Radiation-induced ureteral strictures are a recognized late complication of pelvic radiotherapy for cervical cancer. Repeated double-J (DJ) stenting is often required for urinary drainage in such patients. Stent malposition with intraluminal entrapment above a tight stricture is rare and may render endoscopic retrieval impossible. Case Presentation: We report the case of a 54-year-old hypertensive woman treated for cervical cancer with external beam radiotherapy, brachytherapy, and radical surgery. She developed bilateral lumbar ureteral strictures attributed to prior radiation therapy and required periodic bilateral DJ stent exchanges. During a scheduled stent change performed without fluoroscopic guidance, the right DJ stent was malpositioned, with the distal loop forming within the lumbar ureter proximal to a tight stricture rather than in the bladder. Both rigid and flexible ureteroscopy failed to access or retrieve the entrapped stent due to the non-traversable radiation-induced stricture. A second DJ stent was successfully placed to ensure drainage. Given minimal pelvicalyceal dilatation and preserved renal function, percutaneous nephrostomy was deemed inappropriate. Laparoscopic pyelotomy was performed, allowing identification and removal of the malpositioned stent. Postoperative recovery was uneventful, with preserved renal function and resolution of symptoms. Conclusion: Laparoscopic pyelotomy is a safe and effective minimally invasive option for removal of an entrapped DJ stent when endoscopic and percutaneous approaches are not feasible, particularly in the context of radiation-induced ureteral strictures.