We assessed whether an external ureteropelvic stent was a feasible and safe alternative to Double-J® stent after laparoscopic pyeloplasty in children, thus avoiding a second general anesthesia.
Our study included 22 concurrent age matched children who underwent retroperitoneal laparoscopic pyeloplasty between 2000 and 2008. In group 1 an external ureteropelvic stent was inserted through the renal pelvis, then clamped on postoperative day 2. In group 2 a Double-J stent was antegradely inserted. The ureteropelvic stent was removed at the outpatient clinic on day 10, while the Double-J stent was removed under general anesthesia at 1 month. We retrospectively compared operative time, hospital stay, intraoperative and postoperative complications, and followup.
Mean ± SD age at surgery was 31 ± 9 months in group 1 and 37 ± 12 months in group 2. Mean ± SD operative time was slightly shorter in group 1 (190 ± 40 minutes) than in group 2 (205 ± 23 minutes). No intraoperative complications were encountered during placement of stent. Mean ± SD hospital stay was 2.18 ± 1.20 days in group 1 and 2.45 ± 0.54 days in group 2. No postoperative complications were reported in group 1. The Double-J stent was noted in the posterior urethra in 1 patient in group 2, requiring cystoscopic repositioning. No patient had urinary tract infection. Median followup was 34 months (range 22 to 56) in group 1 and 35 months (16 to 72) in group 2.
The feasibility of external ureteropelvic stenting after laparoscopic pyeloplasty will pave the way to minimizing the use of Double-J stenting and eliminating a second general anesthesia for catheter removal.
Helmy T, Blanc T, Paye-Jaouen A, El-Ghoneimi A. Are you the author?
Reference: J Urol. 2011 Mar;185(3):1065-70.