J Urol. 2026 Mar 6:101097JU0000000000005027. doi: 10.1097/JU.0000000000005027. Online ahead of print.
ABSTRACT
PURPOSE: We sought to review our experience with the postoperative use of ureteral stents with and without extraction strings in a large series of pediatric patients following robotic pyeloplasty (RALP).
MATERIALS AND METHODS: All RALP at our institution from 2012-present were retrospectively reviewed. Patients with <60 days of follow-up, preoperative nephrostomy tubes, and redo pyeloplasty were excluded. Statistical analysis was performed.
RESULTS: A total of 245 patients underwent RALP: 179 (73%) patients had ureteral stents with extraction strings (SWES) and 66 (27%) had internalized stents. Groups were similar with regards to demographics and perioperative characteristics, except for longer operative times in the internalized stent group (p=0.01).No statistically significant difference in postoperative complications (OR 0.77, 95% CI 0.35-1.68, p=0.5) and urinary tract infections (OR 0.72, 95% CI 0.24-2.20, p=0.6) were observed between SWES compared to internalized stents. No difference in Clavien-Dindo Grade 3 complications were seen between groups (OR 1.78, 95% CI 0.49-6.41, p=0.4). Subgroup analysis did not reveal increased risk for postoperative complications or UTI with female gender, prior UTI history, or circumcision status (p≥0.16). Non-use of antibiotic prophylaxis was associated with increased risk of postoperative UTI in the SWES group (p=0.02). Of patients with SWES, 21 (12%) required stent removal in the office setting, 3 (1.7%) required removal in the operating room under anesthesia, and 153 (86%) were able to remove at home.
CONCLUSIONS: Ureteral stents with extraction strings were not associated with an increased risk of postoperative UTI or complications in our series.
PMID:41790987 | DOI:10.1097/JU.0000000000005027
