Urinary diversion during and after pediatric pyeloplasty: A population based analysis of more than 2,000 patients

Renea M. Sturm, Thenappan Chandrasekar, Blythe Durbin-Johnson, Eric A. Kurzrock

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Purpose We evaluated the use and efficacy of intraoperative urinary diversion with ureteral stent or nephrostomy tube during pyeloplasty in children. Materials and Methods The Faculty Practice Solutions Center® national billing database was queried to identify all pediatric pyeloplasties performed from 2009 to 2012. Patient variables, surgical approach, use of intraoperative stent/nephrostomy tube and return for postoperative stent/nephrostomy tube or second pyeloplasty were obtained. Results A total of 2,435 children underwent open (1,792) or laparoscopic/robotic (643) pyeloplasty, with intraoperative urinary diversion rates of 45% and 83%, respectively. Comparing patients with and without an intraoperative stent/nephrostomy tube, 5.6% and 7.4%, respectively, returned to the hospital for urinary diversion. Multivariable analysis revealed no association with surgical approach, but higher surgeon volume (p <0.01) and use of an intraoperative stent/nephrostomy tube (p <0.01) were associated with decreased odds of requiring postoperative urinary diversion. Second pyeloplasty rate was 3.8% and was not associated with surgical approach or use of intraoperative stent/nephrostomy tube. Conclusions Intraoperative stent/nephrostomy tube use and increased surgeon volume were each independently associated with a significant but small decrease in risk of postoperative stent/nephrostomy tube placement. Use of an intraoperative stent/nephrostomy tube was not associated with rate of second (redo ipsilateral or contralateral metachronous) pyeloplasty.

Original languageEnglish (US)
Pages (from-to)214-219
Number of pages6
JournalJournal of Urology
Volume192
Issue number1
DOIs
StatePublished - 2014

Keywords

  • outcome assessment (health care)
  • stents
  • ureter
  • ureteral obstruction
  • urinary diversion

ASJC Scopus subject areas

  • Urology
  • Medicine(all)

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