Pyeloplasty in Children: Advantages of External Trans-Anastomotic Drainage

Abstract

Introduction: There are several forms of successful treatment and prevention for obstruction of the
pyelourethral segment in pediatric patients. However, each method has its advantages and disadvantages.
Namely, some those widespread surgical techniques frequently associate with different complications and
subsequent financial deprivations. Therefore, the optimal method of external trans-anastomotic drainage
is still disputable. In this study, we studied the results of pyeloplasty in children using a transanastomotic
catheter.
Method: In this observational study, which was conducted from 2013 to 2018, we evaluated the outcomes
of pyeloplasty in 132 childrenunder 3 years old. For all patients a trans-anastomotic catheter for urinary
evacuation was used during the postoperative period. The observation period ranged from 6 months to 3
years (an average of 22±6,8 months). Antegrade pyelography was performed in 119 patients on the 6th day
of postoperative period. The average hospital stay was 8.4 days (ranging from 6 to 16 days), most of the
patients were discharged from hospital 7 days after surgery.
Results: 137 pyeloplasty was performed on 132 patients using a transanastomotic catheter. The observation
lasted from 6 months to 3 years. Antegrade pyelography was performed in 119 patients on the 6th day after
surgery. Of those 119 pyelograms taken, 108 (91 percent) showed adequate drainage after pyeloplasty. In 11
patients, partial obstruction was revealed, while in 8 (73 percent) children the possibility of the anastomosis
returned to normal on its own about within 12 days. The transanastomotic catheter was removed on average
7-8 days after surgery. The average hospital stay was 8.4 days.
Conclusion: Urine evacuation with transanastomotic catheter after pyeloplasty in pediatric patients is
highly effective and safe. Other comprehensive studies may be required to prove the further upsides of this
technique.