External extension of double-J ureteral stent during pyeloplasty: inexpensive stent and non-cystoscopic removal.

Abstract

PURPOSE:

The purpose of the study is to describe our experience with the application of externalized double-J ureteral stent (DJUS) during pyeloplasty for correction of ureteropelvic junction obstruction (UPJO) in order to avoid cystoscopy for stent removal.

MATERIALS AND METHODS:

Pyeloplasty was performed in 523 infants with UPJO using miniature pyeloplasty technique. After removing the obstructed segment, a 3-Fr. DJUS was placed into the ureter. In order to avoid cystoscopy for the removal of the stent, a feeding tube was passed through the skin and renal pelvis via a separate stab incision, connected to the DJUS and secured to the external body surface (skin), and the pyeloplasty was completed. The feeding tube along with the stent was removed after 3-4 weeks, respectively. Postoperative follow-up visits were performed 1, 3, and 6 months after the procedure.

RESULTS:

The mean operative time was 49 min (range 41-79). Patients were discharged after 17 ± 2 h (mean ± SD). No patient experienced bladder spasm or anticholinergic administration. Forty-four patients (8.4 %) experienced minor complications including non-febrile urinary tract infections and mild hematuria. No major complication including urinoma, leakage, and stent migration or displacement was observed during the follow-up period. Stent removal was tolerated by 99.8 % of patients in an outpatient setting with minimal discomfort without performing cystoscopy.

CONCLUSIONS:

Using external DJUS along with a pyelocutaneous stent extension during pyeloplasty is a safe, feasible, and beneficial technique. This technique resulted in high success rate with minimal cost and no renal injury. The non-cystoscopic stent removal and elimination of urethral catheterization following pyeloplasty are the other advantages of this technique.

• Authors: Abdol-Mohammad Kajbafzadeh, Atefeh Zeinoddini, Maryam Ebadi, Reza Heidari, Afshin Tajalli
• Journal: International urology and nephrology (Int Urol Nephrol) Vol. 46 Issue 4 Pg. 671-6 (Apr 2014) ISSN: 1573-2584 [Electronic] Netherlands
• PMID: 24202957 (Publication Type: Journal Article)

Topics

• Catheters, Indwelling
• Device Removal (instrumentation, methods)
• Female
• Follow-Up Studies
• Hematuria (etiology)
• Humans
• Infant
• Kidney Pelvis (surgery)
• Male
• Operative Time
• Prosthesis Implantation (adverse effects, instrumentation, methods)
• Stents
• Ureter (surgery)
• Ureteral Obstruction (surgery)
• Urinary Tract Infections (etiology)