Abstract
INTRODUCTION AND OBJECTIVES: DJ stents are widely used in patients who undergo dismembered pyeloplasty for ureteropelvic junction obstruction. However there exist no consensus in terms of optimal stent indwelling time. We therefore evaluated the impact of a short (group A: 2 weeks) compared to a long (group B: 6 weeks) indwelling time on stent related complications and functional outcome. METHODS: Prospective randomized single surgeon series including 82 patients (group A: 41, group B: 41) who underwent minimally invasive dismembered pyeloplasty from 2007 to 2013 at our institution. Preoperatively, baseline split kidney function (scintigraphy) was assessed in all patients. Routinely, retrograde examination with consecutive DJ (4.8 Charr/French, Percuflex Plus Ureteral Stent with HydroPlus Coating, Boston Scientific) placement was performed immediately prior to pyeloplasty. The evaluation of functional outcome was based on objective (renal scintigraphy at 6, 24, 36, 60 months, diuretic renography at 3 months) and subjective findings (flank pain). Statistical analysis was performed with Fisher-test. RESULTS: Median follow up was 24 months (range 3-60) in group A and 24 months (range 3-60) in group B. None of the patients encountered a stent related complication (infection, obstruction, dislocation). Postoperatively, diuretic renography at 3 months showed unobstructed drainage in all 82 patients. Renal scintigraphy detected improved drainage in 91% (32/35) of patients at 6 months and 95% (18/19) of patients at 24 months in group A compared to 95% (36/38) of patients and 96% (23/24) of patients in group B, respectively (p1⁄40.666, p1⁄41). Subjectively, 100% (41/41) of patients in group A compared to 98% (40/ 41) of patients in group B were free of symptoms at last follow up (p1⁄4 1). CONCLUSIONS: Our data demonstrate that 2 weeks stenting provides similarly good periinterventional and functional results compared to 6 weeks stenting. Hence, we suggest that all patients following dismembered pyeloplasty should be uniformly treated with a two weeks DJ stent indwelling interval.
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