Use of external ureteral catheters and internal double J stents in a modified ileal neobladder for continent diversion: a comparative analysis.
BACKGROUND
Open-ended straight ureteral stents are typically used for the support of the ureteroileal anastomosis during the creation of an orthotopic 'S-pouch' ileal neobladder. The use of double J stents as an alternative in this setting is evaluated.


METHODS
Medical charts from 43 patients undergoing radical cystectomy with formation of an ileal 'S-pouch' neobladder were retrospectively evaluated. In 30 patients (group A), a 6-Fr open-ended straight ureteral catheter was used to stent the ureteroileal anastomosis, while a double J stent was used for the same reason in 13 patients (group B). The ureteral catheter was removed 15 days after the procedure while the double J stent 3 weeks postoperatively. Hospital stay, early and late complications were evaluated for both groups during a mean follow-up period of 22.5 and 19.6 months respectively.


RESULTS
Stricture of the ureteroileal anastomosis was observed in 2 (6.6%) and 1 (7.6%) patient of groups A and B respectively. All complications presented with similar rates, except for an increased but not statistically significant incidence of urethrovesical anastomotic leakage and early urinary tract infections in group B. Hospital stay was significantly (p<0.005) shorter for patients of group B (9.9 vs. 15.2 days).


CONCLUSIONS
The use of double J stents to support the ureteroileal anastomosis can be used as an alternative to open-ended ureteral stents. With double J stents a shorter hospital stay was achieved with similar complication rates but a higher incidence of upper urinary tract infections.
Varkarakis
Ioannis M
IM
2nd Department of Urology, Sismanoglio Hospital, University of Athens, Athens, Greece.
Delis
Athanasios
A
Papatsoris
Athanasios
A
Deliveliotis
Charalambos
C
D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D002295:Carcinoma, Transitional Cell / Q000473:pathology / Q000601:surgery; D002404:Catheterization; D015331:Cohort Studies; D015653:Cystectomy / Q000379:methods*; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D015607:Stents; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery; D014546:Urinary Catheterization / Q000295:instrumentation; D014547:Urinary Diversion / Q000295:instrumentation* / Q000379:methods; D016476:Urinary Reservoirs, Continent