Stented versus nonstented pediatric pyeloplasty: a modern series and review of the literature.
OBJECTIVE
Dismembered pyeloplasty remains the principal surgical therapy for pediatric ureteropelvic junction obstruction, although the method of postoperative drainage continues to be debated. We compared stented versus nonstented repairs in a modern series.


METHODS
We evaluated 117 pediatric dismembered pyeloplasties performed by 3 pediatric urologists at 2 institutions from 1991 to 2000. Hospital stay, success rate and complication rate were reviewed. Results were compared with 833 evaluable cases in the literature.


RESULTS
Of the 52 stented repairs urological complications developed in 6 (12%), including symptomatic urinary tract infection in 3 and temporary obstruction in 3. Of the 65 nonstented repairs urological complications developed in 10 (15%), including prolonged leakage in 3, urinoma in 3, obstruction in 3 and urinary tract infection in 1. Mean hospitalization plus or minus standard error was shorter in the stented group (2.1 +/- 0.89 versus 2.6 +/- 1.1 days, p <0.02). We identified 9 previous studies comparing a total of 339 stented with 494 nonstented repairs. Overall the number of complications was almost equal (12% versus 14%) but the stented group had more infections, whereas more leaks occurred in the nonstented group. The nonstented group required more secondary procedures (12 of 339 versus 45 of 494, p = 0.003). Hospital stay was 12 days for stented and 5 days for nonstented repair in these earlier series.


CONCLUSIONS
In children the outcome of stented pyeloplasty is similar to that of nonstented repair. In contrast to previous reports, using a stent for drainage should not necessitate a longer hospital stay.
Smith
Karen E
KE
Division of Urology, Albany Medical College, Department of Urology, University of California-San Francisco Medical Center, San Francisco, California, USA.
Holmes
Nicholas
N
Lieb
Jeremy I
JI
Mandell
James
J
Baskin
Laurence S
LS
Kogan
Barry A
BA
Walker
R Dixon
RD
D002648:Child; D004322:Drainage; D006801:Humans; D007902:Length of Stay; D009403:Nephrostomy, Percutaneous; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents; D014517:Ureteral Obstruction / Q000601:surgery*