Role of routine stentograms following urinary diversion in modern practice

To examine the usefulness of routine stentograms in patient management following urinary diversion.

A retrospective review of all patients undergoing urinary diversion from February 2004 to February 2007 was performed. Three hundred twenty-six patients were identified. One hundred fifty patients were excluded: 101 patients had no stentogram and 49 patients had incomplete records or follow up.

Of the 176 patients, ureteral anastamosic leak was detected in three of 344 ureters (0.9%). The ureteral stents were left in situ until the leaks resolved. None of the three developed a ureteral stricture. Ten (3.0%) ureters had delayed drainage and the stents were removed as scheduled. One patient developed hydronephrosis from a retained portion of the ureteral stent. The 328 ureters (95.4%) with normal stentograms were followed for 30 weeks (3-144). Four ureters (1.25%) developed distal ureteral strictures and one patient developed a ureteral tumor recurrence. No patient developed a poststentogram complication.

The incidence of a ureteral enteric anastamotic leak detected by stentogram is less than 1%-2%. Routine stentograms do not appear necessary in stable patients without clinical signs of a urine leak and thus are now only seldom performed at our institution.