title: Short-term Complications After Pyeloplasty in Children With Lower Urinary Tract Anomalies.
abstract: OBJECTIVE
  To investigate whether children with lower urinary tract (LUT) anomalies are at greater risk for postoperative complications after laparoscopic pyeloplasty stented with a double-J catheter (JJC).
  
  
  METHODS
  Prospectively collected data of laparoscopic pyeloplasty (LP) performed between 2006 and 2015 were analyzed. Inclusion criteria are (1) toilet-trained child and (2) unilateral dismembered pyeloplasty stented with a JJC done by the same surgeon. Our pyeloplasty protocol includes cystoscopy and retrograde pyelography. JJC is left in for 3weeks. Asymptomatic patients with infravesical LUT anomalies (a-LUTA) and those with history of LUT symptoms (LUTS) were identified. Any short-term complication was classified according to Clavien-Dindo. Fisher's exact test was used for statistical analysis.
  
  
  RESULTS
  Fifty-four children (mean 9.8 years) were included. Ten of 54 patients had LUTS. In 4 of those 10, anatomical infravesical anomaly was found during cystoscopy. Accidental urethral anomaly was found in 11 patients (a-LUTA). The control group (CG) consisted of 33 patients. Postoperative hospital stay ranged from 1 to 8 days (mean 2 days). Overall complication rate was 8 of 54 (14%). Grade 1 complications occurred in 3 patients in the CG. Five patients had grade 3 complications (2 needed replacement of bladder catheter, and 3 had diversion of the upper tract). Those problems occurred in 1 of 10 patients with LUTS and 3 of 11 patients with a-LUTA compared to 1 of 33 in the CG. This difference was statistically significant (P < .05).
  
  
  CONCLUSIONS
  Careful history should be taken in toilet-trained children before pyeloplasty. If any infravesical abnormality is discovered, internal diversion should probably be avoided. Special attention must be paid to bladder function in the postoperative period.
authors: Department of Pediatric Urology, University Children's Hospital AMC/EKZ, Amsterdam, The Netherlands; Department of Pediatric Urology, UMC/WKZ, Utrecht, The Netherlands. Electronic address: r.chrzan@amc.nl.
authors: Rafal
authors: R
authors: Chrzan
authors: Department of Urology, 4th Military Hospital, Wroclaw, Poland.
authors: Wojciech
authors: W
authors: Panek
authors: Department of Pediatric Urology, University Children's Hospital AMC/EKZ, Amsterdam, The Netherlands; Department of Pediatric Urology, UMC/WKZ, Utrecht, The Netherlands.
authors: Caroline F
authors: CF
authors: Kuijper
authors: Department of Pediatric Urology, University Children's Hospital AMC/EKZ, Amsterdam, The Netherlands; Department of Pediatric Urology, UMC/WKZ, Utrecht, The Netherlands.
authors: Peter
authors: P
authors: Dik
authors: Department of Pediatric Urology, University Children's Hospital AMC/EKZ, Amsterdam, The Netherlands; Department of Pediatric Urology, UMC/WKZ, Utrecht, The Netherlands.
authors: Aart J
authors: AJ
authors: Klijn
authors: Department of Pediatric Urology, University Children's Hospital AMC/EKZ, Amsterdam, The Netherlands; Department of Pediatric Urology, UMC/WKZ, Utrecht, The Netherlands.
authors: Keetje L
authors: KL
authors: de Mooij
authors: Department of Pediatric Urology, University Children's Hospital AMC/EKZ, Amsterdam, The Netherlands; Department of Pediatric Urology, UMC/WKZ, Utrecht, The Netherlands.
authors: Tom P
authors: TP
authors: de Jong
mesh_terms: D058070:Asymptomatic Diseases; D002648:Child; D003558:Cystoscopy; D005260:Female; D006801:Humans; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects*; D059411:Lower Urinary Tract Symptoms / Q000209:etiology / Q000601:surgery; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D015607:Stents; D014517:Ureteral Obstruction / Q000209:etiology / Q000601:surgery*; D014564:Urogenital Abnormalities / Q000601:surgery*; D014567:Urography