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19–22 APRIL, 2017, BARCELONA, SPAIN
S17-16 (P without presentation)
COMPARING DOUBLE J STENT, EXTERNALIZED
STENTS AND NO STENTS FOLLOWING PYELOPLASTIES
IN INFANTS: DO THEY CHANGE THE FUNCTIONAL
OUTCOME?
Mohammad BADER
1
, Andrew ROBB
2
, Harish CHANDRAN
2
, Karan PARASHAR
2
and Liam MCCARTHY
2
1) Birmingham Children’s Hospital, Paediatric Urology, Birmingham, UNITED KINGDOM - 2) Birmingham
Children’s Hospital, Paediatric Urolgoy, Birmingham, UNITED KINGDOM
PURPOSE
There are advantages and disadvantages of different Stents. Similarly stentless pyeloplasties are
not without complications. We compared stented (Double J stents(JJ), externalized stents(ES))
and stentless (SL) pyeloplasties in infants over 13 years period to see a difference in the functional
outcome and complications.
MATERIAL AND METHODS
All infants who presented with PUJ obstruction were identified from a prospectively collected
database from 2000 to 2013. All infants had open dismembered pyeloplasties. The demograph-
ics, history, pre and post-operative radiological imaging, operation records and follow up data was
analysed. Infants were grouped into 3. Group A were SL, group B had ES and group C had JJ.
Although one surgeon preferred JJ stent but generally they were reserved for infants who had
concomitant VUJ obstruction.
Data given as median (inter-quartile range) and percentage where applicable. Anova test and
paired T test were used to compare the groups. p<0.05 taken as significant.
RESULTS
We reviewed 188 renal units in 185 infants. Age at operation, follow up duration, drainage and loss
of function data is summarized in the table. There was some improvement in function in Group A,
no improvement in group B and slight drop in Group C but none of these were statistical significant.
There was no statistical difference in postoperative leaks (p=0.27), infections(p=0.76), recurrences
(p=0.45), and redo pyeloplasties (p=0.3. Nephrectomies were more common in Group C as com-
pared to other groups (p<0.05).
Group A Group B Group C p value
Number
110
42
36
Age at operation (Months)
7
(5-8.9)
5
(4-7)
5.3
(2.9-7.9)
p<0.01
Follow up duration (years)
2.4
2.2
4.65
p<0.05
Improved drainage (%)
85
83
75
p=0.36
Mean Function (preop:post op) (%)
39:41
40:40
46:43
A:p=0.17
B:p=0.67
C:p=0.26
CONCLUSIONS
Transanastomotic drainage after pyeloplasty in children is controversial. On comparing 3 groups,
although there was no differences in functional outcome in any of these groups. Although nephrec-
tomy rate was significant in JJ stent group.