title: External stent versus double J drainage in patients with radical cystectomy and orthotopic urinary diversion: A randomized controlled trial.
abstract: To compare treatment-related outcomes of ureteral stenting with an external versus double J stent in patients with orthotopic reservoirs after radical cystectomy.
  
  
  
  Patients undergoing radical cystectomy and orthotopic neobladder were randomized into two groups; group I patients received external stents, whereas group II received double J stents. In both groups, preoperative parameters were recorded, and patients were assessed regarding urinary tract infection, urinary leakage, upper tract deterioration, readmission and hospital stay.
  
  
  
  A total of 48 and 45 patients were randomized in the external stent group and double J group, respectively. Both groups were comparable in terms of age, sex, associated comorbidity and oncological status. Early urinary leak was observed in two patients (4.2%) in the external stent group, and in two patients (4.4%) in the double J group (P = 0.95). None of our patients developed ureteral strictures in the external stent group, and one patient did in the double J group (P = 0.3). Positive urine culture (58.3%, 51.1%) as well as febrile urinary tract infections (2.1%, 6.7%) were comparable between both groups, respectively (P = 0.43, 0.28). Wound complications (12.5%, 8.9%) and stent-related complications (2.1%, 0%) were comparable between both groups, respectively (P = 0.57, 0.33). The mean hospital stay was 17.5 days (range 14-32 days) and 14.6 days (range 10-42 days) in both groups, respectively (P = 0.001), with comparable re-admission rates (P = 0.95).
  
  
  
  Incorporation of double J stents in orthotopic urinary diversion is a safe alternative to the routinely used external stenting.
authors.affiliation: Urology and Nephrology Center, Mansoura University, Mansoura, Egypt. y_osman99@yahoo.com.
authors.forename: Yasser
authors.initials: Y
authors.lastname: Osman
authors.affiliation: Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Harraz
authors.affiliation: Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
authors.forename: Tamer S
authors.initials: TS
authors.lastname: Barakat
authors.affiliation: Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
authors.forename: Samer
authors.initials: S
authors.lastname: El-Halwagy
authors.affiliation: Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Mosbah
authors.affiliation: Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
authors.forename: Hassan
authors.initials: H
authors.lastname: Abol-Enein
authors.affiliation: Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
authors.forename: Atallah A
authors.initials: AA
authors.lastname: Shaaban
mesh_terms: D000714:Anastomosis, Surgical; D015653:Cystectomy; D004322:Drainage; D006801:Humans; D015607:Stents; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion
keywords: orthotopic substitute; radical cystectomy; stent, leak, stricture