[The usefulness of the polymeric "double J" catheter in ureteropelvic junction stenting after laparoscopic pyeloplasty].
OBJECTIVE
The aim of the study was to evaluate both the effectiveness of ureteropelvic junction stenting with the use of a polymeric "double J" stent after laparoscopic pyeloplasty, as well as intra- and postoperative complications of the procedure.


METHODS
From October 2001 to November 2010 laparoscopic pyeloplasty was performer in 150 patients with primary UPJO. In all cases an attempt has been made to insert the stent into the operated kidney before the operation. All but one operations were performed using a transperitoneal approach. Anderson-Hynes pyeloplasty was carried out in 85 cases, Y-V plasty in 61 cases and Fenger plasty in 2 patients. Open conversion was performer in two cases.


RESULTS
In 13 cases the complications observed in the postoperastive period were connected with the polymeric stent. In 12 patients the obstruction of the stent lead to massive urinary leakage and in 3 cases from this group urinoma developed. Urinoma was also observed in a patient, who was left without stenting because of the difficulties in inserting the stent to the operated kidney. In 10 cases the stent was successfully replaced but in 3 cases the placement of a percutaneous nephrostomy tube was necessary. It was left in place for 3 weeks.


CONCLUSIONS
Our data indicate, that the stent obstruction is the main cause of postoperative complications in patients after laparoscopic pyeloplasty. So far no better method of upper urinary tract drainage after laparoscopic pyeloplasty has been worked out. Experimenting with various types of stents has been of no avail.
Kliniczny Oddział Urologii, 4 Wojskowy Szpital Kliniczny z Poliklinika we Wrocławiu. szydelko@urol.am.wroc.pl
Tomasz
T
Szydełko
Grzegorz
G
Urbańczyk
Adam
A
Litarski
Wojciech
W
Panek
Artur
A
Pupka
D000328:Adult; D057785:Catheters / Q000009:adverse effects; D004322:Drainage / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000601:surgery*; D007682:Kidney Pelvis / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D015607:Stents / Q000009:adverse effects; D014517:Ureteral Obstruction / Q000209:etiology / Q000517:prevention & control; D013520:Urologic Surgical Procedures / Q000295:instrumentation* / Q000379:methods