[Pyeloureteral plastic operation with or without ureteral intubation]

Application of ureteral splint in corrective operations of the pyeloureteral segment represents still a problem to be discussed, arising diverse opinions regarding its effectiveness. A number of authors consider ureteral intubation as a necessary condition in plastic surgery of pyelone and ureter. Another group of authors reject it and consider it to be unnecessary and even dangerous, due to the possibility of it to cause additional infection and unnecessary traumas due to the splint. In this paper the author presents the postoperative early and late complications, as well as the final results of 34 corrective operations of the pyeloureteral segment, carried out with intubation, and 34 other operations without application of ureter intubation. By comparison of the obtained results it has been concluded that: (1) urinary fistula as an early complication is also possible in the case of operation with splint: (2) postoperative infection is slightly smaller and preoperational existing infection rapidly decreases in the case of operations without splint: (3) postoperational calculosis and stenosis at the place of operation were observed in higher percentage in operations with splint: (4) postoperational hospitalization period was longer for patients operated with splint compared to those operated without splint: and (5) the percentage of successful operations, regardless the stage of pyelocalics dilatations, was higher for operations without intubation of ureter. Based upon these information and the X2 test results author of this paper considers pyeloureteral intubation in pyeloureteral plastics unnecessary, except in extraordinary cases, such as secondary correction of pyeloureteral segment, heavy peripyeloureteritis, narrow and fibrose ureter, multiple and other stenosis, uncertain anastomosis and danger of necrosis at the edges of anastomose where intubation is still required.