Dismembered pyeloplasty with and without after coming stent in neonatal ureteropelvic junction obstruction / Farouk Mohammed Nasser ; Supervised M. Amr Lotfi , Mohammed Said Elsheemy , Ahmed Mahmoud Shouman

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of urology

Pyeloplasty in neonates is very challenging owing to small working space and very small ureter caliber. The use of stents after pyeloplasty has always been debatable, whether to use a stent or not and what type of stent used. The purpose of this study is to compare the outcome of Anderson-Hynes pyeloplasty in neonates either stentless or with after coming stent. Thirty neonates were randomized into two groups and results were revealed. There were 20 males and 10 females with mean age in group A 4 ± 1.4 months (2 - 6) and 3.1 ± 1.8 months (1 - 6) in group B. The mean operative time was 85.3 ± 6.3min (60 - 90) in group A and 92.6 ± 15.3min (70 - 120) in group B. There was no significant difference in operative time between both groups. The mean hospital stay was 5.9 ± 2 days (4 -10) in group A and 3.5 ± 0.8 days (2 - 5). The hospital stay was significant shorter in group (B) with after coming stent. Postoperative complications about 6 cases with leakage in group (A) and one case in group (B) developed high grade fever not responding to antibiotics U/S revealed hydronephrosis with turbid fluid. There was no wound infection or stent slippage. There was significant improvement in both hydronephrosis and DRF in both groups but there was no statistically significant difference between both groups. About two cases needed for subsequent redopyeloplasty. Conclusion: The comparison of the nonstented groups and after coming stented groups during dismembered pyeloplasty in children with UPJ obstruction, we found shorter hospital stay and less postoperative complications (urine leakage) and smooth postoperative period in group (B) with after coming stents.

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