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Ureteroneocystostomy: to drain or not to drain
S H Chow1, M D LaSalle, J A Stock
1Children's Hospital of New Jersey-Saint Barnabas Health Care System, Department of Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, USA.
The Journal of Urology
|August 27, 1998
Summary
External abdominal drains after ureteral reimplantation showed fluid consistent with serum, not urine. Many pediatric urologists question the necessity of these drains, suggesting potential for reduced morbidity in ureteral reimplantation surgery.
Area of Science:
- Pediatric Urology
- Surgical Drainage
- Urologic Surgery
Background:
- The indications for external abdominal drains post-ureteral reimplantation are not well-established.
- Current practices among pediatric urologists regarding drain use vary significantly.
Purpose of the Study:
- To analyze the composition of drainage fluid following ureteral reimplantation.
- To assess the current utilization of external abdominal drains by pediatric urologists.
Main Methods:
- Prospective analysis of drainage fluid (urea, creatinine) in 15 patients undergoing ureteroneocystostomy.
- Comparison of drainage fluid composition to serum values.
- Survey of 268 pediatric urologists on their drain placement practices.
Main Results:
- Drainage fluid urea and creatinine levels were consistent with serum values in all patients.
- The Foley catheter and Jackson-Pratt drains were removed within an average of 3 and 4 days, respectively.
- 73.1% of surveyed urologists use external drains, but 26.5% consider them potentially unnecessary.
Conclusions:
- External abdominal drainage fluid after ureteral reimplantation is serum-consistent, contrary to the belief that it contains urine.
- A significant percentage of pediatric urologists do not routinely use external drains without apparent increased morbidity.
- Further large-scale studies are needed to confirm the necessity of drains in uncomplicated ureteral reimplantation.