Does routine intraoperative Double J stent insertion avoid urine leakage after open partial nephrectomy?

Area of Science:

• Urology
• Surgical Oncology
• Nephrology

Background:

• Open partial nephrectomy (OPN) is a standard procedure for localized kidney tumors.
• Postoperative urinary leakage is a known complication following OPN.
• The use of intraoperative Double J stent (DJS) placement is debated for its potential to mitigate this complication.

Purpose of the Study:

• To investigate the efficacy of intraoperative Double J stent (DJS) insertion in preventing prolonged urinary leakage after open partial nephrectomy (OPN).
• To identify factors associated with postoperative urinary leakage in patients undergoing OPN.

Main Methods:

• Retrospective analysis of 182 patients who underwent OPN between 2002 and 2020.
• Patients were categorized into two groups: those with and without intraoperative DJS placement.
• Statistical analyses, including univariate and multivariate logistic regression, were employed to assess outcomes and predictors of urinary leakage.

Main Results:

• Urinary leakage occurred in 7.6% of all patients and was not significantly different between groups with (9.2%) and without (5.5%) DJS placement (p=0.41).
• Patients with DJS had longer ischemia times and length of stay.
• Tumor proximity to the collecting system was the only independent predictor of postoperative urine leak (p=0.04).

Conclusions:

• Intraoperative DJS insertion during OPN does not significantly decrease the incidence of postoperative urinary leakage.
• Tumor location relative to the collecting system is a critical factor influencing the risk of urine leak.
• The routine use of DJS in OPN may not be beneficial for preventing urinary leakage.