TÇCD 2026 43rd National Congress of Pediatric Surgery - Joint Congress of the Egyptian Society of Pediatric Surgery

Ahmed Hassan, Gameel Aboelgheit, Tamas Cserni

Manchester University

Introduction
In pyeloplasty, double-J (JJ) stents are typically placed in an antegrade fashion without a removal string or with the string cut off. However, leaving a string attached to the bladder end of the stent may allow removal without anaesthesia. This study evaluated the safety and efficacy of a novel home removal technique for JJ stents.

Materials and Methods
Fifty children (40 males, 10 females) with a median age of 4 years (range: 0–15) were included. In 42 laparoscopic and 8 open pyeloplasties, a removal string was either shortened to two-thirds the length of the stent or a 5/0 silk suture was stitched and tied to the bladder end of the stent, followed by antegrade placement. Families were instructed to remove the stent at home once the string appeared at the genitalia. If the thread was not noticed, cystoscopic stent removal was arranged.

Results
The thread was noticed in 27 cases (56%) between 0 and 6.3 weeks (median: 2 weeks) after home removal of the bladder catheter, enabling successful stent removal without anaesthesia. In one patient, the thread detached from the stent during removal, and in two cases, parents inadvertently cut the thread. In 23 patients (44%), the thread was not noticed by parents. During cystoscopy, the strings were found either tangled, too short, or lost. Multivariate analysis revealed no significant factors influencing the success of home removal.

Conclusion
Leaving or attaching a thread to the JJ stent is safe and effectively reduces the need for a second anaesthesia in more than half of the cases

Ahmed Hassan, Gameel Aboelgheit, Tamas Cserni

Manchester University