Does short compared to long ureteral stenting following pyeloplasty offer comparable periinterventional and functional outcomes?

All patients underwent routine physical examination, total blood count, serum biochemistry, and urine analysis and culture prior to surgery. Preoperatively, baseline split kidney function (scintigraphy) was assessed. Additionally, surgery was planned based on either contrast enhanced CT-scan or intravenous urography. Patients received 1.2g amoxicillin and clavulanic acid as perioperative prophylaxis. Routinely, retrograde examination with consecutive ureteral stent (DJ stent) insertion was performed immediately prior to pyeloplasty with the patients already under general anesthesia. Focusing on the main surgical procedure (pyeloplasty), we apply a minimally invasive (pure laparoscopic or robotic assisted laparoscopic) transperitoneal approach using four trocars and the following steps: Initially, the colon is mobilized and reflected. Once the ureter is identified, it is chased to the renal pelvis in order to identify eventually crossing lower pole vessels. Thereafter the ureter is transected at its origin from the renal pelvis and the strictured proximal segment spatulated over 1,5cm. Routinely, the enlarged renal pelvis is reduced in size. With the help of three stay sutures, the uretero-pelvic anastomosis is sawn. Finally, the re-dimensioned pyelon is closed with a running suture and water tightness tested by i.v. Furosemide application. The anastomosis is covered with surrounding tissue/Gerota’s fascia and a drain routinely placed at the anastomosis. The drainage is typically removed if the drained volume is < 20ml/24 hours. The Foley catheter remains for 5 days. In open surgery, ureteral stents were typically removed one week after pyeloplasty (Dobry E, Usai P, Studer UE, Danuser H. Is antegrade pyeloplasty really less invasive than open pyeloplasty? Urologia internationalis. 2007;79(2):152-6). However, nowadays, pyeloplasties are mainly performed through a minimally invasive approach. Fundamentally, DJ stent indwelling time is surgeon dependent and varies somewhere between 1 week and 2 months according to the available literature. While we used to keep the stents for 6 weeks after pyeloplasty in earlier days, this policy has changed over time to a shorter indwelling time around 2 weeks. We therefore aimed to investigate the evantual impact of a short (group A: 2 weeks) compared to a long (group B: 6 weeks) DJ stent indwelling time. DJ-stents were removed in the outpatient clinic after 2 (group A) and 6 weeks (group B), respectively.