Ureteral stents do not cause bacterial infections in children after ureteral reimplantation.
OBJECTIVE
To determine, in a prospective study, the incidence of bacterial colonization and the risk of bacterial infection of indwelling double-J stents in children undergoing ureteral reimplantation. In a balance between the safety and comfort of the child, the need for postoperative stenting of the reimplanted ureters has been discussed. It is unknown whether an indwelling double-J stent after ureteral reimplantation would be a risk factor for postoperative urinary tract infection.


METHODS
From 2005 to 2010, 209 children (138 girls and 71 boys; median age 3.8 years) with vesicoureteral reflux underwent unilateral or bilateral cross-trigonal ureteral reimplantation (352 ureters). All children received a single dose of gentamicin (2 mg/kg body weight) and a preoperative bladder rinse with 10% polividone-saline solution. A transurethral catheter was also left postoperatively for 2 (unilateral) or 3 (bilateral) days. The ureter was stented with a 8-22 cm multilength catheter. At 3 weeks postoperatively, the ureteral catheters were removed and investigated for bacterial colonization.


RESULTS
Of the 209 children, 10 (4.8%) developed a urinary tract infection within the first 6 weeks after ureteral reimplantation. Of the remaining 199 children without any symptoms, 13 (6.5%) had a positive urine culture at removal of the catheters. Of the 199 children without any symptoms, 90 (45.2%) had a positive culture of one or more segments of the double-J catheter.


CONCLUSIONS
Although the colonization rate of ureteral stents in our study was 42.9%, the rate of urinary tract infection during the first 6 weeks after ureteral reimplantation using indwelling ureteral stents was only 4.6%. We have concluded that the clinical significance of bacterial colonization of an indwelling ureteral stent is low, and therefore, ureteral stents can be used safely.
Department of Urology, University Hospitals, Leuven, Belgium.
Pieter
P
Uvin
Anthony
A
Van Baelen
Jan
J
Verhaegen
Guy
G
Bogaert
D000293:Adolescent; D001424:Bacterial Infections / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects*; D014513:Ureter / Q000601:surgery*; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology*; D013520:Urologic Surgical Procedures / Q000379:methods; D014718:Vesico-Ureteral Reflux / Q000601:surgery*