Abstract
Objective
To evaluate the utilization of double-J stents in children with congenital hydronephrosis
in order to avoid or postpone more invasive surgical intervention. Numerous studies
have demonstrated that congenital hydronephrosis caused by ureteropelvic junction
obstruction (UPJO) or primary obstructive megaureter (POM) may require a surgical
correction in up to 20% of cases.
Methods
All infants with severe hydronephrosis and/or an obstructive pattern on renal scintigraphy
that received double-J stent placement between 2010 to 2015 in our center were analyzed.
Children were followed regularly with ultrasound and received antibiotic metaphylaxis.
Urinary tract infection (UTI) and double-J dislocation were defined as complications.
Treatment success was defined as avoidance of surgery and reduction of hydronephrosis
to grade 1 or 0 during the observation period.
Results
29 children were included, in these, 34 (23 UPJO, 7 POM, 4 UPJO and POM) treatment
attempts were performed. Stent implantation failed in six cases, resulting in 28 double-J
stent treatments, of which 19 (69%) were successful within the follow-up period of
20 to 104 months. The most common complications were febrile UTI in 6 of29 cases and
double-J dislocation in 3 of 29 cases.
Conclusion
During the observation period, the success rate of temporary double-J in urodynamically
relevant obstruction was relatively high. However, urinary tract infections and a
complex disease course due to renal stent dislocation, as well as the need for repeated
anesthesia and radiation exposure, should be taken into account. Hence, we do not
recommend double-J stents placement in all children with congenital hydronephrosis;
it may be useful in selected cases.
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Article info
Publication history
Published online: December 03, 2022
Accepted:
November 17,
2022
Received:
April 30,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Funding Source: Internal.
Financial Disclosure: The authors have no financial relationships relevant to this article to disclose.
Conflict of interest: The authors have no conflicts of interest relevant to this article to disclose.
Identification
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