Topic Stent versus stentless pyeloplasty in congenital pelvic ureteric junction obstruction kidney in children

Abstract

Objective: The aim of this study was to compare between stenting and stentless dismembered pyeloplasty as regards outcome, early and late postoperative results, and complications.Background: Ureteropelvic junction obstruction is a common congenital urologic anomaly. Open pyeloplasty is the standard surgical treatment. Drainage following pyeloplasty using a double J stent prevents subsequent stenosis and urine leakage.Patients and Methods: This study was conducted on 50 pediatric patients (maximum age 16 years) with a primary diagnosis of ureteropelvic junction obstruction who were divided into two groups: Group 1, the stented group double J (25 cases). Group 2, the nonstented group (25 cases). Classic Anderson–Hynes pyeloplasty was performed for the two groups.Results: A total of 50 patients were included in the study. 27 (54%) cases were male and 23 (46%) cases were female. Their ages ranged from 6 months to 15 years. The mean ± SD age was 6.75 ± 4.53 years. All cases were unilateral; 25 (50%) cases were right sided and 25 (50%) cases were left sided. Postoperative complications included the following: urinary tract infection in only one case in group 1, residual mild hydronephrosis in only one case in group 1 and three (30%) cases in group 2; clot formation in only one case in group 2, and urinoma in only one case in group 2.Conclusion: Pyeloplasty with a diverting stent is technically feasible and safe. Only risks for multiple anesthesias and economic burden with stent removal are present. The specific indication when stented pyeloplasty needs to be performed is in redo pyeloplasty, solitary kidney, inflamed renal pelvis, and hugely distended renal pelvis.