title: Internal versus external ureteric stents for uretero-ileal anastomosis after laparoscopic radical cystectomy with orthotopic neobladder: A prospective comparative study.
abstract: OBJECTIVE
  To prospectively compare the use of external ureteric stents with internal JJ stenting of the uretero-ileal anastomosis in patients undergoing laparoscopic radical cystectomy (LRC) with a Y-shaped ileal orthotopic neobladder (ON).
  
  
  METHODS
  The study included 69 patients undergoing LRC with ON. Patients were grouped according to the type of uretero-ileal stents used. An external ureteric stent was used in Group A (33 patients) and a JJ stent was used in Group B (36). We prospectively compared the duration of hospital stay, the incidence of short- and intermediate-term complications in the two study groups.
  
  
  RESULTS
  The mean (SD) follow-up periods were 29.18 (3.94) and 28.19 (3.37) months for patients in Groups A and B, respectively. Perioperative patient characteristics were comparable in the two study groups. The use of JJ stenting was associated with a shorter hospital stay compared with external stenting, at a mean (SD) of 14.63 (3.74) and 6.8 (3.03) days in Groups A and B, respectively (P < 0.001). The incidence of urinary leakage was comparable in the two study groups, at 6.1% in Group A vs 8.3% in Group B (P = 1.0). Strictures of the uretero-ileal anastomosis occurred in two patients (6%) in Group A and confirmed by intravenous urography. All strictures were treated with antegrade JJ fixation.
  
  
  CONCLUSIONS
  JJ stents could be used as an effective alternative to external ureteric stents to support the uretero-ileal anastomosis. JJ stenting is associated with a shorter hospital stay and similar complication rates compared with external stenting in patients undergoing LRC with ON.
authors: Department of Urology, Faculty of Medicine, Cairo University, Egypt.
authors: Mahmoud A
authors: MA
authors: Abdel Hakim
authors: Department of Urology, Faculty of Medicine, Cairo University, Egypt.
authors: Ahmed A
authors: AA
authors: Abdalla
authors: Department of Urology, Faculty of Medicine, Cairo University, Egypt.
authors: Ismail R
authors: IR
authors: Saad
authors: Department of Urology, Faculty of Medicine, Cairo University, Egypt.
authors: Mohammed S
authors: MS
authors: ElSheemy
authors: Department of Urology, Faculty of Medicine, Cairo University, Egypt.
authors: Ahmed S
authors: AS
authors: El Feel
authors: Department of Urology, Faculty of Medicine, Cairo University, Egypt.
authors: Hosni K
authors: HK
authors: Salem
authors: Department of Urology, Faculty of Medicine, Cairo University, Egypt.
authors: Amr M
authors: AM
authors: Abdel Hakim
keywords: (L)RC, (laparoscopic) radical cystectomy; ASA, American Society of Anesthesiologists; External ureteral catheters; Ileal neobladder; Internal JJ stents; ON, orthotopic neobladder; US, ultrasonography; Uretero-ileal anastomosis; Urinary diversion