Role of J stent as a minimally invasive treatment option for ureteropelvic junction obstruction.

AIM: The aim of this study was to investigate the factors affecting treatment success in children that got either pyeloplasty or J stent placement in ureteropelvic junction obstruction (UPJO).

PATIENTS AND

METHODS

The study comprised 126 patients who either J stent placement or pyeloplasty performed by the same physician for UPJO from 2012 to 2022. The criteria for surgical intervention adhered to the European Association of Urology (EAU) recommendations. Symptomatic patients with verified obstruction, with a split renal function (SRF) over 40%, low-grade hydronephrosis (Society of Fetal Urology grade 2), and an obstructive segment measuring less than 1 cm, had Double-J stent placement. Furthermore, in infants exhibiting poor health or development retardation, a J stent was inserted as a temporary measure to alleviate obstruction and maintain renal function, notwithstanding the recommendation for pyeloplasty.

RESULTS

The treatment success rate was 43.9% in the J stent group and 88.4% in the pyeloplasty group, with a statistically significant difference (p < 0.001). The kind of procedure (pyeloplasty vs. stent) was the sole independent prognostic factor predicting treatment success (HR: 4.77, p < 0.001) in the multiple logistic regression analysis. No statistically significant change was observed in preoperative and postoperative SRF (48% vs. 48.5%, p = 0.923) among patients with stent failure, confirming a transient preservation of functional advantage.

CONCLUSION

The placement of a stent may have restricted success rates in specific patients with UPJO. Preserving renal function may be advantageous until definitive surgery, particularly in cases where there are hazards associated with anesthesia and invasive procedures.