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Image-guided pediatric ureteric stent insertions: an 11-year experience
Madeleine Sertic1, Joao Amaral1, Dimitri Parra1
1Image Guided Therapy, Diagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8.
Insights
Double J ureteric stent placement in children by interventional radiologists is highly effective, with 95% technical and functional success rates. This image-guided procedure offers a safe treatment option for pediatric urologic obstructive conditions.
Area of Science:
- Pediatric Urology
- Interventional Radiology
- Medical Device Technology
Background:
- Urologic obstructive conditions in children can lead to significant morbidity.
- Double J ureteric stents are crucial for managing these conditions.
- Minimally invasive techniques are preferred for pediatric interventions.
Purpose of the Study:
- To evaluate the technical success and complication rates of double J ureteric stent placements in pediatric patients.
- To assess the efficacy of image-guided stent insertion performed by interventional radiologists.
Main Methods:
- Retrospective analysis of 59 double J ureteric stent placements in 35 pediatric patients (2001-2011).
- Data included patient demographics, procedural details, success rates, and complications.
- Descriptive statistics were used to analyze the outcomes.
Main Results:
- Technical success rate was 95% (56/59) and primary functional success was 95% (53/56).
- 49 procedures were performed, including de novo insertions and exchanges.
- Complications were low, with two minor intra-procedural and four post-procedural events.
Conclusions:
- Image-guided double J ureteric stent insertion is an effective treatment for pediatric urologic obstructive conditions.
- The procedure demonstrates high technical and functional success rates in pediatric patients.
- Interventional radiology offers a safe and effective approach for pediatric stent placement.
Purpose:
To report the technical success and complication rates for double J ureteric stent placements by interventional radiologists in children.
Materials And Methods:
A retrospective analysis of double J ureteric stents placed between January 2001 and December 2011 was conducted. Data collected included patient demographics, procedural details (indication, double J stent size, access approach, concurrent procedures), technical and functional success, tube dwell time, and procedure-related complications. Descriptive statistics were employed. Placement of 59 double J ureteric stents was attempted in 49 procedures performed on 35 pediatric patients (26 boys and 9 girls) with a mean age of 7.3 years (range, 22 d-17.9 y; median age, 4 y) and a mean weight of 22 kg (range, 2.5-70 kg).
Results:
There were 44 de novo double J stent insertion attempts: 20 one-stage procedures (17 anterograde, 3 retrograde through the urethra) and 24 two-stage anterograde procedures through an existing nephrostomy tube. There were 15 exchanges; 11 were anterograde, and 4 were retrograde (2 urethral, 2 Mitrofanoff). Of 49 procedures, 15 were performed as combined procedures with a urologist. Technical success was 95% (56 of 59), and primary functional success was 95% (53 of 56). Complications included two minor complications occurring during the procedure and four complications occurring after the procedure.
Conclusions:
Image-guided insertion of a double J ureteric stent is an effective treatment for pediatric urologic obstructive conditions. The procedure is both technically and functionally successful in a high percentage of pediatric patients.
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