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• W2085433009 abstract "No AccessJournal of UrologyPediatric urology1 Feb 2007Usefulness of Short-Term Retrievable Ureteral Stent in Pediatric Laparoscopic Pyeloplasty Selcuk Yucel, Mindy L. Samuelson, Michael T. Nguyen, and Linda A. Baker Selcuk YucelSelcuk Yucel Department of Urology, Akdeniz University School of Medicine, Antalya, Turkey Supported by Akdeniz University Scientific Research and Project Unit. More articles by this author , Mindy L. SamuelsonMindy L. Samuelson Department of Urology, University of Texas Southwestern Medical Center at Dallas and Children’s Medical Center, Dallas, Texas Department of Urology, Akdeniz University School of Medicine, Antalya, Turkey More articles by this author , Michael T. NguyenMichael T. Nguyen Department of Urology, University of Texas Southwestern Medical Center at Dallas and Children’s Medical Center, Dallas, Texas Department of Urology, Akdeniz University School of Medicine, Antalya, Turkey More articles by this author , and Linda A. BakerLinda A. Baker Department of Urology, University of Texas Southwestern Medical Center at Dallas and Children’s Medical Center, Dallas, Texas Department of Urology, Akdeniz University School of Medicine, Antalya, Turkey More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2006.10.017AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Methods of stenting after laparoscopic pyeloplasty have included indwelling Double-J® stents and percutaneous nephrostomy tubes. The disadvantages of these methods are that they necessitate a second surgery for stent removal or require an external drainage bag. To circumvent these issues, the tolerance, safety and outcomes of using a Double-J ureteral stent with a dangler, permitting early office removal, was investigated in a series of pediatric laparoscopic pyeloplasties. Materials and Methods: Medical records from a consecutive series of pediatric patients undergoing transperitoneal laparoscopic pyeloplasties were reviewed. Indications for surgery included ipsilateral flank pain with severe hydronephrosis (12 patients), recurrent pyelonephritis with severe hydronephrosis (2), and hematuria and flank pain (6). All patients were discharged home within 24 to 48 hours of the procedure with prophylactic oral antibiotics. The stent was removed by postoperative day 18 during a followup office visit. Patient tolerance of the indwelling stent, outpatient removal and success of pyeloplasty were assessed. Results: A total of 20 patients underwent transperitoneal laparoscopic pyeloplasty by 1 surgeon (LAB) between 2001 and 2005. All patients underwent cystoscopy and retrograde Double-J ureteral stent placement before pyeloplasty under the same anesthesia. Mean patient age at operation was 11.3 years (median 11.3, range 4.6 to 17.2). Stents were left indwelling for a mean of 10.3 days (median 10, range 7 to 18). All patients tolerated the Double-J stent well, with 2 requiring anticholinergic therapy for mild urgency symptoms and 1 demonstrating urinary tract infection. All patients tolerated outpatient stent removal via the dangler at the office without discomfort. One patient was lost to followup. At a mean followup of 1.04 years (range 0.1 to 2.88) 17 of 19 patients (89%) had resolution of flank pain/urinary tract infections, with sonographic improvement in hydronephrosis with or without endoscopic intervention. Six patients (30%) had flank pain with or without continuous hydronephrosis and required re-stenting, and 3 also required balloon dilation. Of these 6 patients 2 (10%) had recurrent ureteropelvic junction obstruction and required open pyeloplasty. All patients are now clinically and radiologically unobstructed and asymptomatic. Conclusions: Pediatric transperitoneal laparoscopic pyeloplasty with indwelling Double-J ureteral stent with a dangler is successful and the stent is well tolerated. Whether the duration of ureteral stenting affects the surgical success will require further controlled long-term studies. References 1 : Laparoscopic dismembered pyeloplasty. J Urol1993; 150: 1795. Link, Google Scholar 2 : Comparison of dismembered and nondismembered laparoscopic pyeloplasty in the pediatric patient. J Endourol2004; 18: 875. Google Scholar 3 : Laparoscopic dismembered pyeloplasty: 50 consecutive cases. BJU Int2001; 88: 526. Google Scholar 4 : Laparoscopic dismembered pyeloplasty by a retroperitoneal approach in children. BJU Int2003; 92: 104. Google Scholar 5 : Laparoscopic pyeloplasty: the first 100 cases. J Urol2002; 167: 1253. Link, Google Scholar 6 : Is antegrade stenting superior to retrograde stenting in laparoscopic pyeloplasty?. J Urol2004; 171: 1440. 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Google Scholar 15 : Priorities in urinary diversion following pyeloplasty. J Urol1989; 142: 576. Link, Google Scholar 16 : Stented versus nonstented pediatric pyeloplasty: a modern series and review of the literature. J Urol2002; 168: 1127. Link, Google Scholar 17 : Robotic assisted laparoscopic pyeloplasty in children. J Urol2005; 174: 1440. Link, Google Scholar 18 : Computer assisted pyeloplasty in children: the retroperitoneal approach. J Urol2004; 171: 2629. Link, Google Scholar 19 : Management of secondary ureteropelvic junction obstruction after failed primary laparoscopic pyeloplasty. J Urol2004; 172: 180. Link, Google Scholar 20 : Does retrograde balloon dilation compromise outcome of secondary open pyeloplasty: 17 years’ experience at a single center. Urology2005; 66: 1172. Google Scholar 21 : Laparoscopic transabdominal pyeloplasty in children is feasible irrespective of age. J Urol2006; 175: 688. Link, Google Scholar © 2007 by American Urological AssociationFiguresReferencesRelatedDetailsCited byHelmy T, Blanc T, Paye-Jaouen A and El-Ghoneimi A (2011) Preliminary Experience With External Ureteropelvic Stent: Alternative to Double-J Stent in Laparoscopic Pyeloplasty in ChildrenJournal of Urology, VOL. 185, NO. 3, (1065-1070), Online publication date: 1-Mar-2011.Braga L, Lorenzo A, Farhat W, Bägli D, Khoury A and Pippi Salle J (2008) Outcome Analysis and Cost Comparison Between Externalized Pyeloureteral and Standard Stents in 470 Consecutive Open PyeloplastiesJournal of Urology, VOL. 180, NO. 4S, (1693-1699), Online publication date: 1-Oct-2008.Corrales J, Meza M, Quiche J and Zorrilla J (2008) A Technique for the Removal of Ureteral Catheters in Infants and Children Using a Urethral SoundJournal of Urology, VOL. 180, NO. 1, (295-296), Online publication date: 1-Jul-2008. Volume 177Issue 2February 2007Page: 720-725 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordslaparoscopychildureteral obstructionurologic surgical proceduresMetricsAuthor Information Selcuk Yucel Department of Urology, Akdeniz University School of Medicine, Antalya, Turkey Supported by Akdeniz University Scientific Research and Project Unit. More articles by this author Mindy L. Samuelson Department of Urology, University of Texas Southwestern Medical Center at Dallas and Children’s Medical Center, Dallas, Texas Department of Urology, Akdeniz University School of Medicine, Antalya, Turkey More articles by this author Michael T. Nguyen Department of Urology, University of Texas Southwestern Medical Center at Dallas and Children’s Medical Center, Dallas, Texas Department of Urology, Akdeniz University School of Medicine, Antalya, Turkey More articles by this author Linda A. Baker Department of Urology, University of Texas Southwestern Medical Center at Dallas and Children’s Medical Center, Dallas, Texas Department of Urology, Akdeniz University School of Medicine, Antalya, Turkey More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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