The use of double-j ureteric stents in children with a megaureter: a single-centre experience

Abstract

Purpose Ureteric tapering and reimplantation is the established treatment for a megaureter that fails to resolve. We have used endoscopically placed double-J stents in children for the treatment of persistent or progressive megaureter. Here we present the results of our experience including outcomes and complications of stent placement and removal. Material and methods A retrospective case-note review of all patients having received double-J stents for the treatment of an obstructed megaureter over an 8-year period from 1997-2004 was performed. Patient demographics, post-operative complications, duration of follow-up and the results of follow-up investigations and need for further surgery were recorded. Results We inserted 37 double-J stents in 31 children. All patients underwent pre-operative assessment with USS and dynamic radionuclide renography Patient age at time of insertion ranged from 4 months to 16 years with a median age of 3 years. Follow-up was for a mean of 46 months. Complications were uncommon and minor in nature, most commonly post-operative haematuria which was managed conservatively. The use of a double-J stent followed by subsequent removal after a minimum of 4 months demonstrated signficant improvement in 25/37 ureters, the remainder underwent ureteric tapering and reimplantation. Conclusions Endoscopic placement of double-J stents in childhood is straightforward and complications are uncommon. Megaureter causing hydronephrosis resolves in over 2/3 of cases. Therefore endoscopic placement of double-J stents should be considered as a first line treatment in the management of persistent or progressive megaureter causing hydronephrosis or sepsis.