[Use of double J ureteral stent as an alternative to prevent ureteroileal anastomosis stricture in orthotopic bladder substitution].
OBJECTIVE
The aim of the study was to compare ureteroileal anastomosis strictures rates in patients receiving either double J stent or open-ended ureteral stent, after bladder replacement for cancer.


METHODS
Medical charts from 75 patients who underwent cystectomy and Z pouch bladder substitution for bladder cancer, between 2001 and 2005, were retrospectively reviewed. Ureteroileal anastomosis was direct, spatulated end-to-side fashioned in all patients. Double J stents were used in 39 patients (group A) and open-ended ureteral stent were used in 36 patients (group B). Mean hospital stay, early and late complications were also observed.


RESULTS
Seventeen anastomotic strictures have been documented during the follow-up: 5.2% in group A versus 18.3% in group B (p=0.012). Mean catheterization period was six weeks in group A and 12 days in group B. No significant differences were found in mean hospital stay, early and late complications.


CONCLUSIONS
The use of internal double J ureteral stent is now a feasible option and can decrease the rate of anastomotic stricture. The fact that the double J stent is removed after the anastomosis healing period may be a possible explanation.
Echo
H
H
Service d'urologie, hôpital Cochin, groupe hospitalier Cochin St-Vincent-de-Paul, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France. hovsep.echo@cch.aphp.fr
Zerbib
M
M
Saighi
D
D
Amsellem-Ouazana
D
D
Flam
T
T
Debré
B
B
Peyromaure
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D003251:Constriction, Pathologic / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007082:Ileum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents; D014513:Ureter / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion / Q000009:adverse effects* / Q000379:methods*