A randomized control trial comparing outcome after stented and nonstented Anderson-Hynes dismembered pyeloplasty

• Published in: Journal of Indian Association of Pediatric Surgeons 2018-10, Vol.23 (4), p.186-191
• Main Authors: Nagdeve, Nilesh, Bhingare, Pravin, Sarawade, Prashant
• Format: Article
• Language: English
• Subjects: Analysis; Antibiotics; Diuretics; Nonstented pyeloplasty; Original; Pain; Patients; Pediatrics; Postoperative period; randomized control trial; Statistical analysis; stented pyeloplasty; Stents; ureteropelvic junction obstruction; Urinary tract diseases; Urinary tract infections; Urine; Urogenital system
• ISSN: 0971-9261; 1998-3891
• DOI: 10.4103/jiaps.JIAPS_58_17

Aim: The aim of the study was to compare the efficacy and postoperative complications of stented and nonstented open pediatric dismembered pyeloplasty for ureteropelvic junction (UPJ) obstruction. Settings and Design: A balanced, parallel group, prospective randomized controlled trial comparing stented and nonstented Anderson-Hynes Dismembered Pyeloplasty. Subjects and Methods: It included 42 children who required Anderson-Hynes dismembered pyeloplasty for UPJ obstruction (UPJO). Patients were randomized into stented (double "J" [DJ] stent) and nonstented pyeloplasty groups. The intraoperative and postoperative course was compared. Both groups were analyzed for problems such as dysuria, frequency, pain, hematuria and urinary tract infection, and postoperative renal status. Statistical Analysis: Mann-Whitney U-test, Fisher's exact test, Student's t-tests, and Chi-squared test were used. Results: Surgical duration was significantly shorter for the nonstented group as compared to the stented group (60.4 ± 6.49 min vs. 78.9 ± 8.17 min). The intraoperative negotiation of DJ stent was troublesome in 21.7% patients belonging to the stented group. The hospital stay was comparable in both groups (4.67 ± 1.9 vs. 4.28 ± 0.67 days). Patients in stented group had experienced dysuria, loin pain, lower abdominal spasmodic pain, and frequency significantly higher than nonstented group. However, the other problems such as fever, hematuria, and urinary tract infections were more common in stented group, but the difference was not statistically significant. There was no difference in resolution of hydronephrosis in both groups. Conclusions: There is no statistically significant difference in resolution of hydronephrosis following nonstented or stented dismembered pyeloplasty in children with UPJO. However, the patient is more symptomatic due to stent in the postoperative period.