Ureteroneocystostomy without urethral catheterization shortens hospital stay without compromising postoperative success

David T. Duong, Dipen J Parekh, John C. Pope IV, Mark C. Adams, John W. Brock, Lane Palmer, George Kaplan, Mark Cain, Richard Grady

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Purpose: We determine whether routinely performing catheterless ureteroneocystostomy would minimize hospital stays without compromising postoperative outcomes. Materials and Methods: Between May 1996 and February 2002 patients who underwent ureteroneocystostomy at a single major tertiary care institution were identified. Patients who underwent additional, simultaneous surgical procedures were excluded from the study. Data recorded included patient demographics, reflux grade, use of a bladder catheter, length of hospital stay, medication use, postoperative complications and subsequent rehospitalization. Results: Of the 300 patients included in the study 266 were girls and 34 were boys, with a median age of 4 years (range 3 months to 19 years). Reimplantation was bilateral in 215 cases and unilateral in 85. Reflux was grade I in 1% of cases, grade II in 18%, grade III in 47%, grade IV in 25% and grade V in 9%. Similar distributions were observed among the 76 patients who received bladder catheters and the 224 who did not. The average length of postoperative hospitalization for patients who received catheters compared to those who did not was 2.1 versus 1.4 days (p <0.001), and the rate of prolonged hospitalization are 18% versus 5%, respectively (p <0.01). Postoperative complication rates were 17% versus 8% (p <0.05) for patients who received catheters compared to those who did not. There was no statistically significant difference in the rate of rehospitalization whether urethral catheters were used (1.3% vs 4.9%, respectively, p = 0.07). Furthermore, there was no statistically significant difference in the amount of either ketorolac or oxybutynin used by patients who received catheters compared to those who did not. Conclusions: Surgical repair of vesicoureteral reflux via catheterless ureteroneocystostomy can reduce hospital stay without adversely affecting complication rates, rehospitalization rates and the amount of medications needed postoperatively.

Original languageEnglish
Pages (from-to)1570-1573
Number of pages4
JournalJournal of Urology
Volume170
Issue number4 II
DOIs
StatePublished - Oct 1 2003
Externally publishedYes

Fingerprint

Urinary Catheterization
Length of Stay
Catheters
Urinary Bladder
Hospitalization
Ketorolac
Urinary Catheters
Vesico-Ureteral Reflux
Replantation
Tertiary Healthcare
Demography

Keywords

  • Catheterization
  • Reimplantation ureter
  • Urethra
  • Vesicoureteral reflux

ASJC Scopus subject areas

  • Urology

Cite this

Ureteroneocystostomy without urethral catheterization shortens hospital stay without compromising postoperative success. / Duong, David T.; Parekh, Dipen J; Pope IV, John C.; Adams, Mark C.; Brock, John W.; Palmer, Lane; Kaplan, George; Cain, Mark; Grady, Richard.

In: Journal of Urology, Vol. 170, No. 4 II, 01.10.2003, p. 1570-1573.

Research output: Contribution to journalArticle

Duong, DT, Parekh, DJ, Pope IV, JC, Adams, MC, Brock, JW, Palmer, L, Kaplan, G, Cain, M & Grady, R 2003, 'Ureteroneocystostomy without urethral catheterization shortens hospital stay without compromising postoperative success', Journal of Urology, vol. 170, no. 4 II, pp. 1570-1573. https://doi.org/10.1097/01.ju.0000084144.50541.3d
Duong, David T. ; Parekh, Dipen J ; Pope IV, John C. ; Adams, Mark C. ; Brock, John W. ; Palmer, Lane ; Kaplan, George ; Cain, Mark ; Grady, Richard. / Ureteroneocystostomy without urethral catheterization shortens hospital stay without compromising postoperative success. In: Journal of Urology. 2003 ; Vol. 170, No. 4 II. pp. 1570-1573.
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abstract = "Purpose: We determine whether routinely performing catheterless ureteroneocystostomy would minimize hospital stays without compromising postoperative outcomes. Materials and Methods: Between May 1996 and February 2002 patients who underwent ureteroneocystostomy at a single major tertiary care institution were identified. Patients who underwent additional, simultaneous surgical procedures were excluded from the study. Data recorded included patient demographics, reflux grade, use of a bladder catheter, length of hospital stay, medication use, postoperative complications and subsequent rehospitalization. Results: Of the 300 patients included in the study 266 were girls and 34 were boys, with a median age of 4 years (range 3 months to 19 years). Reimplantation was bilateral in 215 cases and unilateral in 85. Reflux was grade I in 1{\%} of cases, grade II in 18{\%}, grade III in 47{\%}, grade IV in 25{\%} and grade V in 9{\%}. Similar distributions were observed among the 76 patients who received bladder catheters and the 224 who did not. The average length of postoperative hospitalization for patients who received catheters compared to those who did not was 2.1 versus 1.4 days (p <0.001), and the rate of prolonged hospitalization are 18{\%} versus 5{\%}, respectively (p <0.01). Postoperative complication rates were 17{\%} versus 8{\%} (p <0.05) for patients who received catheters compared to those who did not. There was no statistically significant difference in the rate of rehospitalization whether urethral catheters were used (1.3{\%} vs 4.9{\%}, respectively, p = 0.07). Furthermore, there was no statistically significant difference in the amount of either ketorolac or oxybutynin used by patients who received catheters compared to those who did not. Conclusions: Surgical repair of vesicoureteral reflux via catheterless ureteroneocystostomy can reduce hospital stay without adversely affecting complication rates, rehospitalization rates and the amount of medications needed postoperatively.",
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AU - Duong, David T.

AU - Parekh, Dipen J

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AU - Adams, Mark C.

AU - Brock, John W.

AU - Palmer, Lane

AU - Kaplan, George

AU - Cain, Mark

AU - Grady, Richard

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N2 - Purpose: We determine whether routinely performing catheterless ureteroneocystostomy would minimize hospital stays without compromising postoperative outcomes. Materials and Methods: Between May 1996 and February 2002 patients who underwent ureteroneocystostomy at a single major tertiary care institution were identified. Patients who underwent additional, simultaneous surgical procedures were excluded from the study. Data recorded included patient demographics, reflux grade, use of a bladder catheter, length of hospital stay, medication use, postoperative complications and subsequent rehospitalization. Results: Of the 300 patients included in the study 266 were girls and 34 were boys, with a median age of 4 years (range 3 months to 19 years). Reimplantation was bilateral in 215 cases and unilateral in 85. Reflux was grade I in 1% of cases, grade II in 18%, grade III in 47%, grade IV in 25% and grade V in 9%. Similar distributions were observed among the 76 patients who received bladder catheters and the 224 who did not. The average length of postoperative hospitalization for patients who received catheters compared to those who did not was 2.1 versus 1.4 days (p <0.001), and the rate of prolonged hospitalization are 18% versus 5%, respectively (p <0.01). Postoperative complication rates were 17% versus 8% (p <0.05) for patients who received catheters compared to those who did not. There was no statistically significant difference in the rate of rehospitalization whether urethral catheters were used (1.3% vs 4.9%, respectively, p = 0.07). Furthermore, there was no statistically significant difference in the amount of either ketorolac or oxybutynin used by patients who received catheters compared to those who did not. Conclusions: Surgical repair of vesicoureteral reflux via catheterless ureteroneocystostomy can reduce hospital stay without adversely affecting complication rates, rehospitalization rates and the amount of medications needed postoperatively.

AB - Purpose: We determine whether routinely performing catheterless ureteroneocystostomy would minimize hospital stays without compromising postoperative outcomes. Materials and Methods: Between May 1996 and February 2002 patients who underwent ureteroneocystostomy at a single major tertiary care institution were identified. Patients who underwent additional, simultaneous surgical procedures were excluded from the study. Data recorded included patient demographics, reflux grade, use of a bladder catheter, length of hospital stay, medication use, postoperative complications and subsequent rehospitalization. Results: Of the 300 patients included in the study 266 were girls and 34 were boys, with a median age of 4 years (range 3 months to 19 years). Reimplantation was bilateral in 215 cases and unilateral in 85. Reflux was grade I in 1% of cases, grade II in 18%, grade III in 47%, grade IV in 25% and grade V in 9%. Similar distributions were observed among the 76 patients who received bladder catheters and the 224 who did not. The average length of postoperative hospitalization for patients who received catheters compared to those who did not was 2.1 versus 1.4 days (p <0.001), and the rate of prolonged hospitalization are 18% versus 5%, respectively (p <0.01). Postoperative complication rates were 17% versus 8% (p <0.05) for patients who received catheters compared to those who did not. There was no statistically significant difference in the rate of rehospitalization whether urethral catheters were used (1.3% vs 4.9%, respectively, p = 0.07). Furthermore, there was no statistically significant difference in the amount of either ketorolac or oxybutynin used by patients who received catheters compared to those who did not. Conclusions: Surgical repair of vesicoureteral reflux via catheterless ureteroneocystostomy can reduce hospital stay without adversely affecting complication rates, rehospitalization rates and the amount of medications needed postoperatively.

KW - Catheterization

KW - Reimplantation ureter

KW - Urethra

KW - Vesicoureteral reflux

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