MAAUA: 2007 Abstracts - String-Extraction For Pediatric Ureteral Stents And Reconstructive Surgery

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String-Extraction For Pediatric Ureteral Stents And Reconstructive Surgery
Craig A Peters, Fern Campbell*
University of Virginia, Charlottesville, VA

Introduction: We assessed the efficacy of using ureteral stents with extraction strings in children undergoing robotic pyeloplasty, uretero-ureterostomy, and open megaureter tapering.
Methods: Patients undergoing robotic pyeloplasty, uretero-ureterostomy, and open megaureter repair were assessed as to duration and tolerance of double J stenting depending upon whether a string was attached. In those undergoing megaureter repair, hospital stay was assessed. Parents and patients chose whether to use a string extractable stent. If no string was used, patients underwent anesthesia and cystoscopic stent extraction; for those with a string, the stent was removed in the office.
Results: 26 patients underwent laparoscopic pyeloplasty or uretero-ureterostomy (11 no string; 10 string) and 5 had a megaureter repair. Laparoscopic cases had stents removed at a mean of 20 days post-op. One infant removed his prematurely, but suffered no ill effects; one boyâ€™s stent came out with his Foley catheter, but was without sequelae. Two patients had voiding discomfort, managed by Pyridium and anticholinergics. Stents removed by cystoscopy were in for a mean of 31 days. Children with megaureter repair were in hospital for 2 days and stents were removed a mean of 14 days post-op.
Conclusion: The use of stents with strings for easy office removal have been useful in managing pediatric reconstruction. These data suggest that stents with extraction strings are well tolerated, safe and efficacious in a broad range of patients and avoids cystoscopy under anesthesia or the need for prolonged hospital stay for a megaureter repair.

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