title: A 5-Fr Externalized Nephroureteral Catheter as the Sole Protective Device for Pediatric Pyeloplasty: The Experiences of 142 Patients.
abstract: BACKGROUND
  Pyeloplasty for ureteropelvic junction obstruction correction is a common procedure, but the optimal method for protective diversion after pyeloplasty is still a matter of debate.
  
  
  OBJECTIVE
  Here, we present our clinical trial experience using a single percutaneous externalized nephroureteral (NU) 5-Fr catheter (infant feeding tube) with multiple side holes as the sole instrument of drainage to provide a protective mechanism.
  
  
  METHODS
  In this prospective study, we analyzed the charts of 142 patients who underwent pyeloplasty from August 2001 through October 2008. We used a single externalized NU 5-Fr catheter with multiple side holes for postoperative upper tract diversion. The catheter was removed in the office after 10 - 14 days. Complications from the use of this catheter, including poor catheter function, premature dislodgement, urinary tract infection, leakage, urinoma, and anastomotic stenosis, were evaluated. The operations were performed by two surgeons at two separate centers.
  
  
  RESULTS
  In all, 148 pyeloplasty procedures were performed on 142 patients. The mean hospital stay length was 2 (1 - 3) days. A contrast study through a catheter demonstrated excellent drainage with no leakage in all patients. Immediately after catheter removal, febrile urinary tract infection and transient obstructive symptoms and signs occurred in 15 patients.
  
  
  CONCLUSIONS
  Using a percutaneous externalized NU 5-Fr catheter was sufficient as a protective measure after open pyeloplasty. It costs less than other diverting systems, such as DJ, and can be removed in the office. Therefore, it can be a safe and cost effective procedure, especially in developing countries where cystoscopic set ups are not readily available. There were only a few notable complications.
authors.affiliation: Department of Pediatric Surgery, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mansour
authors.initials: M
authors.lastname: Mollaeian
authors.affiliation: Department of Pediatric Surgery, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Ghavami-Adel
authors.affiliation: Department of Pediatric Surgery, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Farid
authors.initials: F
authors.lastname: Eskandari
authors.affiliation: General physician, Tehran, IR Iran.
authors.forename: Arash
authors.initials: A
authors.lastname: Mollaeian
keywords: Diversion; Nephroureteral Catheter; Percutaneous Catheter; Pyeloplasty; UPJO