Abstract:
Abstract.
Introduction. Urinary drainage is a key part of ureteropelvic junction obstruction treatment. Both external and
internal drainage methods have been widely used for many
years, but there is now relevant research comparing these
methods and their impact on surgical outcomes in adults.
The aim of the current research was to assess the efficacy
and safety of two different types of urinary drainage on
adult pyeloplasty.
Material and methods. We conducted a retrospective
and prospective clinical controlled study in the Department
of Urology at the Republican Clinical Hospital from Chisinau. We reviewed 118 consecutive adult pyeloplasties for
ureteropelvic junction obstruction. In 62 (52.54%) patients,
we used double-J ureteral stent insertion (DJ); in another
56 (47.46%) patients, we used different types of external
drainage (ED): uretero-pyelo-nephrostomy, nephrostomy,
or a combination of both. Operative time, hospital stay, use
of analgesics, overall complications, type of complications,
and success rates were compared between the two groups.
Results. The mean operative time in the DJ group was
93.52±18.10 min. vs. 95.77±20.48 min. in the ED group (p
= 0.001). The average postoperative hospital stay in the DJ
group was 8.45±2.02 days vs. 14.71±3.45 days in the ED
group (p=0.000). The DJ group used 7.77±3.48 analgesics
on average, while the ED group used 9.86±4.64 (p = 0.006).
Overall complication rate was 9.68% in the DJ group and
32.14% in the ED group (p = 0.002). The most frequent
complication for all patients was acute pyelonephritis
(12.71%): 4.84% in the DJ group vs. 21.43% in the ED group
(p = 0.007). The success rate was 96.77% in the DJ group
and 92.86% in the ED group.
Conclusions. Both urinary drainage methods appear
equivalent concerning overall success rates, but double-J
ureteral stents are associated with a shorter operating time,
fewer postoperative pain medications, a shorter postoperative hospital stay, and a lower number of postoperative
complications compared with external urinary drainage
methods.
