Abstract
PurposeThe purpose of this study is to provide a new strategy for non-cystoscopic double J urethral stent (JJS) removal, the transurethral retrograde fishing the double J urethral stent (TURFJJS), that avoids general anesthesia in pediatric populations.MethodsWe retrospectively reviewed the JJS removal records of patients having ureteropelvic junction obstruction (UPJO). We analyzed differences in the removal success rates, operation-related severe complications, total cost, duration, and parental satisfaction between TURFJJS and traditional cystoscopic double J urethral stent removal (CJJSR) procedures.ResultsA total of 324 patients with UPJO were included in this study. CJJSR yielded a success rate of 100%. TURFJJS achieved a success rate of 94.3%. The TURFJJS was just an outpatient procedure, and its total cost was about 800 Chinese yuan (US$ 124). There were no severe JJS removal-related complications using TURFJJS. Parental satisfaction was 98.2 and 92.5% for the CJJSR and TURFJJS protocols, respectively.ConclusionTURFJJS is safe, effective, cost-effective, and well-tolerated in pediatric patients, minimizing or eliminating the need for general anesthesia, additional hospitalization, and waste of time. TURFJJS should be widely used in pediatric urology.
Highlights
Hydronephrosis is the dilation of the renal collecting system and is one of the most common congenital anomalies in pediatric urology, occurring at a rate of 0.13–0.16% among children [1]
A latest network meta-analysis concluded that compared with other drainage strategies, indwelling of double J ureteral stent (JJS) after surgery appears to be more beneficial for pediatric pyeloplasty in view of its ranked results [7]
165 underwent traditional cystoscopic double J urethral stent removal (CJJSR), whereas 159 cases were treated by TURFJJS
Summary
Hydronephrosis is the dilation of the renal collecting system and is one of the most common congenital anomalies in pediatric urology, occurring at a rate of 0.13–0.16% among children [1]. A latest network meta-analysis concluded that compared with other drainage strategies, indwelling of JJS after surgery appears to be more beneficial for pediatric pyeloplasty in view of its ranked results [7]. The JJS can be removed at an outpatient clinic via traditional cystoscopic double J urethral removal (CJJSR). This operation is safe, quick, and well-tolerated and has a success rate of approximately 100%. According to the literature, pediatric patients usually need to be hospitalized, and the removal of the JJS is performed under general anesthesia due to the inability of the patient to tolerate CJJSR under local anesthesia, which greatly increases patient burden and wastes medical resources [8, 9]
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