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Can double J stent complications be reduced in pediatric patients?
M Bayarri Moreno1, I Planas Díaz1, I Casal Beloy1
1Pediatric Surgery Department. Hospital Universitario Virgen del Rocío. Sevilla (Spain).
Insights
Double J (DJ) stent complications in pediatric urology are linked to stent duration, bilaterality, and multiple stents. Improved medical record keeping can reduce DJ stent issues, and routine antibiotic prophylaxis may not be beneficial.
Area of Science:
- Pediatric Urology
- Medical Device Complications
Background:
- Double J (DJ) stents are commonly used in pediatric urology but are associated with potential morbidity.
- Understanding risk factors for DJ stent complications is crucial for improving patient outcomes.
Purpose of the Study:
- To identify risk factors associated with double J (DJ) stent complications in pediatric patients.
- To evaluate the quality of information provided to families regarding DJ stent placement and care.
Main Methods:
- A retrospective study analyzed 180 pediatric patients (236 DJ stents) from 2017-2022.
- Patients were categorized into complicated and non-complicated groups to identify complication-related risk factors.
- A family satisfaction survey assessed the perceived quality of information provided about DJ stents.
Main Results:
- The overall complication rate was 21.9%.
- Risk factors for complications included having more than one stent (OR=6.628) and bilateral placement (OR=4.871).
- Inadequate medical record registration correlated with increased complications, while antibiotic prophylaxis showed no significant benefit.
Conclusions:
- DJ stent morbidity is associated with stent duration, bilaterality, and the number of stents used.
- Accurate medical record keeping is linked to shorter DJ stent duration and fewer complications.
- The routine use of antibiotic prophylaxis for DJ stents warrants reconsideration due to lack of demonstrated benefit.
Objective:
The use of double J (DJ) stents is frequent in urological pediatrics, but it is not exempt from morbidity. The objective of this study was to describe the risk factors (RF) of DJ complications in pediatric patients, and to analyze the quality of the information provided to the families with respect to the stent.
Materials And Methods:
A retrospective study of patients undergoing surgery with DJ placement in the urology department from 2017 to 2022 was carried out. Study patients were divided into two groups -complicated (C) and non-complicated (NC). A multivariate analysis was performed to identify complication-related RFs, and a quality analysis as perceived by the families was conducted by means of a satisfaction survey (0 = total dissatisfaction; 10 = maximum satisfaction).
Results:
180 patients were included (236 DJs). The main diagnoses included renal transplantation (29.8%), ureteropelvic stenosis (26%), and urolithiasis (20.7%). Complication rate was 21.9%, with a mean comprehensive complication index (CCI) of 26.8. Prophylactic antibiotic therapy was not associated with fewer complications (97.3% vs. 98.1%; p= 0.727). Complication RFs included more than one stent (p< 0.001; OR= 6.628) and bilateral placement (p< 0.05; OR= 4.871). Poor registration in the medical records was associated with greater complications (p= 0.025). In the information quality survey, 20% reported a score lower than 7/10.
Conclusions:
DJ-associated morbidity has a direct relationship with DJ duration, bilaterality, and carrying more than one stent in a lifetime. Adequate registration in the medical records is associated with shorter DJ duration, and therefore, fewer complications. Antibiotic prophylaxis did not reduce complications, which means its routine use should be reconsidered.
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