Double-J ureteral stents: an alternative to external urinary stents in orthotopic bladder substitution.
Eur Urol
; 39(5): 575-9, 2001 May.
Article
em En
| MEDLINE
| ID: mdl-11464040
ABSTRACT
OBJECTIVE:
The aim of this study was to compare advantages and disadvantages of using double-J or external stents to preserve the uretero-ileal anastomosis in patients receiving an orthotopic neobladder.METHODS:
77 consecutive patients with bladder cancer who underwent radical cystoprostatectomy and Studer neobladder were evaluated. All patients received a direct spatulated end-to-side uretero-ileal anastomosis in the afferent loop (Nesbit technique). In 45 patients (group A), the stents (Bracci ureteral splint) were brought our through the reservoir and anchored to the skin; in 32 patients (group B), an internal double-J stent was used. Median follow-up was 30 months.RESULTS:
9 (11.5%) uretero-ileal anastomosis strictures in group A and 7 (11.6%) in group B were observed. There was a significant difference in the side of stricture with a greater prevalence on the left side (p<0.004). Stricture formation and side were not related to the type of stent used. 14 (20%) neobladder-ureteral refluxes occurred, with a non-significant difference between the two groups (p = 0.37). 12 patients (86%) were asymptomatic; two patients developed pyelonephritis and needed antibiotic treatment. Neobladder catheter was removed after 17 days (range 15-18 days) and 14 days (range 12-15 days), respectively, in group A and group B with an earlier discharge of the patients in group B. There was a significant difference in mean hospital stay between the two groups (Mann-Whitney test p<0.0001). Discomfort related to the stent was mild for most of the patients of group B (84%).CONCLUSIONS:
Internal stenting is an equally effective alternative to external stent in patients undergoing bladder replacement. The use of double-j stents appears to be associated with minimal discomfort, earlier mobilization and a shorter hospital stay.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Derivação Urinária
/
Bexiga Urinária
/
Stents
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Limite:
Aged
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Eur Urol
Ano de publicação:
2001
Tipo de documento:
Article
País de afiliação:
Itália
País de publicação:
CH
/
SUIZA
/
SUÍÇA
/
SWITZERLAND