Trans-uretero-cystic external urethral stent for urinary diversion in pediatric laparoscopic pyeloplasty: A novel approach

Medicine (Baltimore). 2020 Oct 16;99(42):e22135. doi: 10.1097/MD.0000000000022135.

Abstract

Purpose: We present a new approach for urine drainage in pediatric patients following laparoscopic pyeloplasty, the trans-uretero-cystic external urethral stent (TEUS).

Methods: We retrospectively identified 85 children who underwent laparoscopic pyeloplasty from July 2015 to June 2017. The included children were assigned to group A (double-J stent) or group B (TEUS). In group A, the double-J stent was removed by a cystoscopy under anesthesia after 1 month, while in group B, the external stent was removed after 5 to 7 days. We examined the durations of operation, hospital stay and the frequency of stent-related complications including urinary leakage, stent dislocation, stent occlusion, and urinary tract infection.

Results: The operation time was significantly longer for patients in group B than for those in group A. No significant difference was observed between the groups regarding stent-related complications. In group A, 4 patients need auxiliary stent re-insertion for the management of complications, 2 developed urinary tract infection, and 2 had stent occlusion. In group B, none needed auxiliary stent re-insertion for complications and avoided re-operation.

Conclusions: In children, the outcome of external stent implantation was similar to that using double-J stent, and the use of the former approach may be beneficial for younger children.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cystoscopy
  • Device Removal
  • Female
  • Humans
  • Infant
  • Laparoscopy / methods*
  • Length of Stay / statistics & numerical data
  • Male
  • Operative Time
  • Postoperative Complications
  • Retrospective Studies
  • Stents*
  • Ureteral Obstruction / surgery*
  • Urinary Diversion / methods
  • Urologic Surgical Procedures / methods*