Complications and length of hospital stay following stented and unstented paediatric pyeloplasties.

OBJECTIVES

To ascertain the necessity for the use of nephrostomies and ureteric stents after paediatric pyeloplasties.

PATIENTS AND METHODS

Seventy children with a pelvi-ureteric junction obstruction underwent a dismembered pyeloplasty between March 1983 and March 1991 at The Bristol Royal Hospital for Sick Children. A nephrostomy and stent were not used routinely except for the first few months of the survey. Indications for their use were: surgery on a single kidney, an inflamed renal pelvis or a revision pyeloplasty. Urinary catheters were only used for those patients with proven or suspected vesicoureteric reflux.

RESULTS

Thirteen patients had a nephrostomy and stent inserted (Group 1) of whom three patients (23%) developed complications. Fifty-seven patients had only a wound drain inserted (Group 2) of whom nine (16%) developed complications. The hospital stay of 12.1 days for patients in Group 1 was significantly longer than the 5.4 days for Group 2 (P value < 0.05). Long-term radiological and/or radio-isotopic follow-up showed improvement in function and/or drainage in 95% of both groups.

CONCLUSIONS

These findings support the concept that paediatric pyeloplasties can be safely performed at any age without the insertion of a nephrostomy tube or stent and that hospital stay is therefore significantly reduced.