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Risk of Postoperative Urinary Tract Infection and Complications With Ureteral Stents With and Without Extraction

Nikhil V Batra1, Hannah Dillon1, Rosalia Misseri1

  • 1Riley Hospital for Children at Indiana University School of Medicine, Indianapolis, Indiana.

The Journal of Urology
|March 6, 2026
PubMed

Insights

Ureteral stents with extraction strings are safe for pediatric robotic pyeloplasty patients. These stents did not increase the risk of urinary tract infections or complications compared to internalized stents.

Area of Science:

  • Urology
  • Pediatric Surgery

Background:

  • Robotic pyeloplasty (RALP) is a common procedure in pediatric urology.
  • Postoperative ureteral stenting is frequently employed to ensure adequate healing and drainage.
  • The choice between ureteral stents with extraction strings (SWES) and internalized stents can impact patient management and outcomes.

Purpose of the Study:

  • To evaluate the safety and efficacy of ureteral stents with extraction strings (SWES) versus internalized stents in pediatric patients undergoing robotic pyeloplasty (RALP).
  • To compare postoperative complication rates, including urinary tract infections (UTIs), between the two types of ureteral stents.

Main Methods:

  • Retrospective review of all RALP procedures performed at the institution from 2012 to the present.
  • Exclusion criteria included less than 60 days of follow-up, preoperative nephrostomy tubes, and redo pyeloplasty.
  • Statistical analysis was performed to compare outcomes between patients with SWES and internalized stents.

Main Results:

  • A total of 245 pediatric patients underwent RALP, with 179 (73%) receiving SWES and 66 (27%) receiving internalized stents.
  • No statistically significant differences were observed in postoperative complications (p=0.5) or urinary tract infections (p=0.6) between the SWES and internalized stent groups.
  • While not statistically significant, longer operative times were noted in the internalized stent group (p=0.01).
  • Non-use of antibiotic prophylaxis was associated with an increased risk of postoperative UTI in the SWES group (p=0.02).

Conclusions:

  • Ureteral stents with extraction strings are a safe option for pediatric patients following robotic pyeloplasty.
  • SWES do not appear to increase the risk of postoperative complications or urinary tract infections compared to internalized stents.
  • The majority of SWES (86%) were successfully removed at home, simplifying postoperative care.
Abstract

Keywords:
UTIcomplicationsminimally invasive surgerypyeloplastyureteropelvic junction obstruction

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