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Non-Invasive Stent Removal after Ureteroneocystostomy in Pediatric Patients: Long-Term Results
1Cengiz Gokcek Maternity and Children Hospital, Department of Pediatric Urology, Gaziantep, Turkey.. yasarissi@yahoo.com.
Insights
Removing double-J stents (DJS) after pediatric ureteroneocystostomy (UNC) without anesthesia is safe and effective. This less invasive approach yields comparable long-term outcomes to traditional methods, avoiding the need for general anesthesia.
Area of Science:
- Pediatric Urology
- Surgical Innovation
- Minimally Invasive Procedures
Background:
- General anesthesia poses risks in pediatric urological interventions.
- Ureteroneocystostomy (UNC) often requires double-J stent (DJS) placement.
- Evaluating anesthesia-free stent removal is crucial for patient safety.
Purpose of the Study:
- To investigate the efficacy and safety of anesthesia-free double-J stent removal after pediatric ureteroneocystostomy.
- To compare outcomes of early, non-anesthetized DJS removal with standard, later removal under anesthesia.
Main Methods:
- Retrospective study of 25 pediatric patients undergoing UNC.
- Group 1: DJS removed on postoperative day 4 without anesthesia or cystoscopy (sutured to catheter).
- Group 2: DJS removed 3-4 weeks post-op under anesthesia with cystoscopy (standard method).
Main Results:
- No statistically significant difference in long-term renal function between groups.
- Comparable hydronephrosis regression rates in both groups.
- Early DJS removal without anesthesia was feasible and safe.
Conclusions:
- Anesthesia-free DJS removal in pediatric UNC is a viable, less invasive alternative.
- This method offers comparable safety and long-term results to the standard approach.
- Avoids risks associated with general anesthesia in pediatric patients.
Objective:
Among the more serious problems in urological interventions among the pediatric age group is the requirement of general anesthesia. The advantages of removing a double-J stent (DJS) without anesthesia in ureteroneocystostomy (UNC) operations among children were investigated in this study.
Patients And Methods:
In all, 25 patients who underwent UNC surgery between November 2016 and November 2018 were retrospectively divided into two groups according to the method used for the removal of the DJS. In Group 1, the stent was tied to the urethral catheter by a suture and retrieved postoperatively on the fourth day without anesthesia and cystoscopy. In Group 2, we inserted the stent according to the classical method with no suturing to the catheter and removed it 3 to 4 weeks after the first operation, with cystoscopy under anesthesia.
Results:
A total of 16 girls and 9 boys were included in the study. The mean age was 4.3 and 6.3 years in groups 1 and 2, respectively. We did not observe statistically significant difference between the groups in long-term renal function or hydronephrosis regression.
Conclusion:
We consider that the removal of a stent placed in pediatric intravesical UNC operations without anesthesia and cystoscopy is less invasive and affords safety and long-term results comparable to the standard method.
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