Risk of Postoperative Urinary Tract Infection and Complications With Ureteral Stents With and Without Extraction Strings in Pediatric Robotic Pyeloplasty.

PURPOSE: We sought to review our experience with the postoperative use of ureteral stents with and without extraction strings in a large series of pediatric patients following robotic-assisted laparoscopic pyeloplasty (RALP).

MATERIALS AND

METHODS

All RALPs at our institution from 2012 to present were retrospectively reviewed. Patients with < 60 days of follow-up, preoperative nephrostomy tubes, and redo pyeloplasty were excluded. Statistical analysis was performed.

RESULTS

A total of 245 patients underwent RALP: 179 (73%) patients had ureteral stents with extraction strings (SWES) and 66 (27%) had internalized stents. Groups were similar with regard to demographics and perioperative characteristics, except for longer operative times in the internalized stent group (P = .01). No statistically significant difference in postoperative complications (odds ratio [OR] 0.77, 95% CI 0.35-1.68, P = .5) or UTIs (OR 0.72, 95% CI 0.24-2.20, P = .6) were observed between SWES compared with internalized stents. No difference in Clavien-Dindo grade 3 complications was seen between groups (OR 1.78, 95% CI 0.49-6.41, P = .4). Subgroup analysis did not reveal an increased risk of postoperative complications or UTI with female sex, UTI history, or circumcision status (P ≥ .16). Nonuse of antibiotic prophylaxis was associated with an increased risk of postoperative UTI in the SWES group (P = .02). Of patients with SWES, 21 (12%) required stent removal in the office setting, 3 (1.7%) required removal in the operating room under anesthesia, and 153 (86%) were able to remove at home.

CONCLUSIONS

Ureteral SWES were not associated with an increased risk of postoperative UTI or complications in our series.