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Use of Temporary Double-J Stent Placement for Children With Congenital Hydronephrosis: A Long-Term Single-Center

Nina Hutflesz1, Michael Boettcher1, Susanne Deeg1

  • 1Department of Pediatric and Adolescent Surgery, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany.

Urology
|December 8, 2022
PubMed

Insights

Double-J stents can successfully treat congenital hydronephrosis in children, avoiding surgery in many cases. However, complications like urinary tract infections and stent dislocation necessitate careful patient selection for this intervention.

Area of Science:

  • Pediatric Urology
  • Nephrology
  • Surgical Innovation

Background:

  • Congenital hydronephrosis, often due to ureteropelvic junction obstruction (UPJO) or primary obstructive megaureter (POM), may necessitate surgical intervention in up to 20% of pediatric cases.
  • Double-J stents are explored as a less invasive option to manage these conditions.

Purpose of the Study:

  • To evaluate the effectiveness of double-J stent utilization in pediatric patients diagnosed with congenital hydronephrosis.
  • To determine if double-J stents can postpone or eliminate the need for invasive surgical procedures.

Main Methods:

  • Retrospective analysis of infants with severe hydronephrosis and/or obstructive patterns on renal scintigraphy who underwent double-J stent placement between 2010-2015.
  • Regular follow-up with ultrasound and antibiotic metaphylaxis; complications defined as urinary tract infection (UTI) and double-J dislocation.
  • Treatment success defined as surgical avoidance and reduction of hydronephrosis grade.

Main Results:

  • Out of 29 children and 34 treatment attempts (23 UPJO, 7 POM), 28 double-J stent treatments were performed after 6 initial failures.
  • A 69% success rate was observed across 19 treatments, with a follow-up period ranging from 20 to 104 months.
  • Common complications included febrile UTI (6/29 cases) and double-J dislocation (3/29 cases).

Conclusions:

  • Temporary double-J stent placement demonstrated a relatively high success rate in managing urodynamically significant obstructions in children.
  • Urinary tract infections, stent dislocation, and the need for repeated anesthesia/radiation are significant considerations.
  • Double-J stents are not universally recommended for all pediatric congenital hydronephrosis cases but may be beneficial in selected patients.
Abstract

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