Stent vs Stentless Ileal Conduits After Radical Cystectomy: Is There a Difference in Early Postoperative Outcomes?

Area of Science:

• Urology
• Surgical Oncology
• Medical Device Innovation

Background:

• Ureteral stents are commonly placed during radical cystectomy with ileal conduit (RCIC) procedures.
• Emerging evidence suggests omitting stents may be feasible.

Purpose of the Study:

• To compare perioperative and 30-day outcomes between stented and stentless RCIC.
• To evaluate the necessity of ureteral stents in ileal conduit urinary diversion.

Main Methods:

• Retrospective analysis of 5418 RCIC cases from 2019-2021 using the NSQIP database.
• Comparison of baseline characteristics and 30-day outcomes (UTIs, AKI, leaks, reoperations, readmissions) between stented and stentless groups.
• Statistical analysis using Pearson's χ² and t-tests, with P < .05 considered significant.

Main Results:

• No significant differences in baseline demographics or comorbidities were observed.
• Stentless RCIC had similar 30-day outcomes for UTIs, AKI, renal failure, anastomotic leaks, ureteral obstruction, reoperations, and readmissions.
• Stented patients had a lower rate of urinary leak or fistula formation (3.1% vs 4.8%, P = .04).

Conclusions:

• Stentless RCIC procedures demonstrated noninferior outcomes compared to stented procedures for most key 30-day outcomes.
• The findings suggest that ureteral stents may not be essential for ileal conduit urinary diversion.