Percutaneous insertion of double-J ureteral stent in children with ureteral obstruction: Our experiences

Abstract

ObjectiveUreteral obstruction (UO) is usually treated by surgical or endoscopic approaches. We investigated whether percutaneous anterograde treatment with insertion of double-J ureteral stent (DJ) is a feasible alternative technique for the management of UO in selected cases, where traditional approaches are not possible or too risky. Patients and methodsThe DJ was percutaneously inserted into 10 children (mean age 9 years) who suffered from UO. Three children had already been treated surgically for complex urotract congenital anomalies; six children had restenosis/reocclusion or stenosis of ureteropelvic junction; and one girl suffered migration of an intraoperatively placed DJ with stenosis of the distal ureter. ResultsPercutaneous insertion of the DJ was successful on the first attempt in 8 and on the second in 2 children. Adverse events after the procedure, all successfully treated, included one pyelonephritis and one migration of DJ, and 3 children had bacteriuria and 3 hematuria. Mean duration of insertion of the DJ was 6.4 months. After removal of the DJ, 7 children did not need any further interventions, but 2 children needed surgical correction and 1 reinsertion of the DJ. ConclusionIn selected cases, percutanous insertion of a DJ should be considered as an alternative to surgery or endoscopic treatment in the management of children with UO.