The role of routine postoperative stentograms in the pediatric patient undergoing excisional tapered ureteral reimplantation

Abstract 

Objective

To determine the usefulness of routine stentograms in postoperative management of pediatric patients undergoing excisional tapered ureteral reimplantation.

Materials and methods

A retrospective review of all pediatric patients undergoing excisional tapered ureteral reimplantation from March 2003 to March 2008 at one center was performed. One hundred patients were identified. Seventeen had stentograms performed approximately 2 weeks (1–5 weeks) after surgery. The 83 without stentograms composed the control group.

Results

Of the 17 pediatric patients with postoperative stentograms, 10 (59%) had no contrast observed in the bladder. Ureteral stents were removed despite this finding. No anastamotic leaks were observed. In this group, not one had a postoperative complication at time of follow up (mean 25 months; range 4–52). Of the 83 patients without stentograms, not one had clinical signs of anastamotic leakage or obstruction at discharge. The stents were removed routinely 2 weeks (range 1–8) after surgery. Nine patients (10.8%) developed ureteral obstruction (mean 7 weeks; range 1–24) requiring intervention. Three of these patients required a second operation.

Conclusions

Since routine stentograms rarely identify ureteral leak, and poor drainage on postoperative stentogram does not indicate a risk of obstruction, these studies are not required following routine excisional tapered ureteral reimplant.

Keywords: Stentogram, Ureteral reimplantation, Stents, Ureteroneocystostomy