title: Pyeloplasty for hydronephrosis: Issues of double J stent versus nephrostomy tube as drainage technique.
abstract: OBJECTIVE
  To compare the efficacy, complications, cost analysis and hospital stay between two methods of drainage of the kidney: double J (DJ) stent versus nephrostomy tube following open pyeloplasty for ureteropelvic junction obstruction hydronephrosis.
  
  
  METHODS
  This was a prospective randomized study of 20 patients in each group over 14 months. Pre and post-operative (3 months) function and drainage were assessed by ethylenedicysteine scan and intravenous urogram.
  
  
  RESULTS
  Both groups showed similar good improvement in function and drainage. Nephrostomy group had significantly longer hospital stay (P < 0.001) but incurred less cost. Complications with nephrostomy included tube breakage (n = 1) and urine leak after tube removal (n = 2). DJ stents were associated with stent migration (n = 4), increased frequency of micturition (n = 9), dysuria (n = 4) and urinary tract infection (n = 1).
  
  
  CONCLUSIONS
  Both methods of drainage did not interfere with improvement after pyeloplasty. Minor complications were more with DJ stent (P = 0.0003). Although overall cost of treatment was more with stents, they reduced length of hospital stay. Optimal length of stent is essential to reduce complications secondary to migration and bladder irritation.
authors.affiliation: Department of Pediatric Surgery, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India.
authors.forename: Ravi Kumar
authors.initials: RK
authors.lastname: Garg
authors.affiliation: Department of Pediatric Surgery, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India.
authors.forename: Prema
authors.initials: P
authors.lastname: Menon
authors.affiliation: Department of Pediatric Surgery, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India.
authors.forename: Katragadda Lakshmi
authors.initials: KL
authors.lastname: Narasimha Rao
authors.affiliation: Department of Anaesthesia and Intensive Care, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India.
authors.forename: Suman
authors.initials: S
authors.lastname: Arora
authors.affiliation: Department of Anaesthesia and Intensive Care, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India.
authors.forename: Yatindra Kumar
authors.initials: YK
authors.lastname: Batra
keywords: Dismembered pyeloplasty; double J stent; hydronephrosis; nephrostomy; pediatric; ureteropelvic junction obstruction