One week stenting after pediatric laparoscopic pyeloplasty; is it enough?

Area of Science:

• Pediatric Urology
• Minimally Invasive Surgery
• Urologic Oncology

Background:

• The optimal duration of ureteric stent placement after pediatric pyeloplasty is debated.
• Standard 4-6 week stenting can lead to complications and requires general anesthesia for removal in children.
• Laparoscopic pyeloplasty is a common procedure for ureteropelvic junction obstruction (UPJO) in pediatric patients.

Purpose of the Study:

• To evaluate the outcomes of short-term ureteric stenting following laparoscopic pyeloplasty in pediatric patients.
• To compare the safety and efficacy of 1-week stenting versus 4-week stenting.

Main Methods:

• A prospective randomized study included 37 children under 16 with UPJO undergoing laparoscopic pyeloplasty.
• Group A (18 patients) had stents removed after 4 weeks under general anesthesia.
• Group B (19 patients) had stents removed after 1 week with the urethral catheter in an outpatient setting.

Main Results:

• No significant differences in operative time, leakage, hospital stay, or early complications between groups.
• Both groups showed similar improvements in symptoms, ultrasound, and renal scans.
• Group A had a significantly higher incidence of irritative voiding symptoms and urinary tract infections post-removal.

Conclusions:

• Short-term ureteric stenting (1 week) is a safe and effective alternative to standard 4-week stenting after pediatric laparoscopic pyeloplasty.
• This approach reduces stent-related morbidity, including lower rates of infection and voiding dysfunction.
• Outpatient removal without anesthesia is a significant advantage for pediatric patients.