Is Routine Double-J Stenting Necessary in Pediatric Pyeloplasty?

Area of Science:

• Urology
• Pediatric Surgery
• Surgical Outcomes

Background:

• The necessity of routine double-J (DJ) ureteral stents in pediatric pyeloplasty, especially in open surgery, is debated.
• While common in minimally invasive techniques, their impact on postoperative complications requires further investigation.

Purpose of the Study:

• To evaluate the influence of routine DJ stent use on postoperative complication rates in pediatric pyeloplasty.
• To compare outcomes between stented and non-stented pediatric pyeloplasty cases across multiple institutions.

Main Methods:

• Retrospective analysis of a multicenter international database of pediatric pyeloplasty cases (open, laparoscopic, robotic).
• Patients were categorized based on DJ stent utilization (presence or absence).
• Primary outcome: overall postoperative complication rate; Secondary outcomes: UTI, reoperation, length of stay.

Main Results:

• No statistically significant difference in complication rates between stented (26.7%) and non-stented (20.4%) groups (p=0.39).
• Reoperation rates (3.7% vs 4.5%, p=0.81) and rates of UTI and length of stay were also comparable.
• Outcomes were consistent across different surgical approaches and stenting strategies.

Conclusions:

• Routine use of DJ stents does not appear to decrease postoperative complications in pediatric pyeloplasty.
• Comparable outcomes suggest that routine DJ placement may be unnecessary for most open pyeloplasty procedures.
• A selective stenting strategy, rather than universal use, is supported by these findings.