Vol. 6, Issue 1, Part C (2024)

Ureteropelvic junction obstruction with resultant hydronephrosis is the most common cause of upper urinary tract dilatation. Anderson-Hynes (A-H) pyeloplasty is the gold standard for managing ureteropelvic junction obstruction, boasting success rates above 90%. Double J stents are commonly employed post-surgery, but there is no consensus on the optimal indwelling time. Traditionally, stents are left for 4-6 weeks; however, recent suggestions indicate that one week may be sufficient for effective outcomes. This hospital-based quasi-experimental study aimed to compare early versus long-term stenting following A-H pyeloplasty for ureteropelvic junction obstruction by assessing postoperative outcomes. Conducted at Dhaka Medical College and Hospital from July 2022 to June 2023, the study involved 64 patients aged 13-40 years who underwent open pyeloplasty. Patients were divided into Group A (long-term stenting, 4 weeks) and Group B (short-term stenting, 1 week). Outcome measures included urinary tract infection, stent colonization, anastomotic leakage, urine culture results, split differential renal function, split glomerular filtration rate and T1/2 isotope clearance in DTPA renogram, evaluated over a six-month follow-up. This study results showed that Group B had a significantly lower incidence of post-operative UTI (12.5% vs. 46.87%) and stent colonization with Escherichia coli (6.25% vs. 34.32%) and Proteus (0% vs. 12.50%) compared to Group A. Both groups showed similar rates of anastomotic leakage (2 cases in Group B and 1 in Group A). Improvement in DRF, GFR, and T1/2 in DTPA renogram after six months was comparable between groups, with no significant statistical differences (P=0.318, P=0.276, P=0.068 respectively). In conclusion, early removal of D-J stents following A-H pyeloplasty for ureteropelvic junction obstruction is preferable due to a lower incidence of urinary tract infection and stent colonization, with similar long-term functional outcomes compared to prolonged stenting.