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Background: Pyeloplasty with double J stents often require postoperative urethral catheterization, manipulation of the UVJ and a second anesthetic for removal in pediatric patients. In contrast, pyeloplasty with externalized ureteropyelostomy “Salle” stents avoids these issues. We compare outcomes of laparoscopic and open pyeloplasty with Salle stents compared to double J stents in pediatric patients.
Methods: 76 patients underwent surgery for ureteropelvic junction (UPJ) obstruction from January 2011 to July 2012 by five pediatric urologists at the Hospital for Sick Children. Exclusion criteria included ureterocalicostomy, complex concomitant surgery, drainage with ureteral catheter, stentless pyeloplasty or patients who were lost to follow-up. Twenty four patients had a Salle stent and 39 patients had a double J stent post-pyeloplasty.
Results: Median follow-up was 9.1 months (0.7-24.6). Median age for the Salle stent group was 40 months and the double J group was 78 mos (p=0.04). The Salle stent group had a greater number of open pyeloplasty (71%) versus the double J group (41%), which approached but did not reach statistical significance (p=0.06). There was no statistically significant difference in operative time, length of stay and overall complication rate between the two groups.
Conclusions: Laparoscopic or open pyeloplasty using Salle stents does not prolong operative time, length of stay or alter complication rate when compared to double J stents. Salle stents are a safe alternative and have many advantages over conventional double J stents.