Closed External End Double J Catheter as a Nephrostent in Pyeloplasty for Infants with Uretero-Pelvic Junction Obstruction

Uretero-Pelvic Junction Obstruction (UPJO) is a common congenital anomaly that may need pyeloplasty to prevent renal function deterioration. The purpose of this study was to describe a modified use of jj stent catheter in pyeloplasty for infant with UPJO. A series of 12 children, between 3 and 10 months, underwent stenting open pyeloplasty. In each patient a 6 French Foley catheter was placed within the bladder. One ml sterile methylene blue was instilled into the catheter, which was clamped during the operation time. During a dismembered pyeloplasty, a small (3F) double j stent was placed through the flank into renal pelvis, passing the flank skin, muscles and entering via lower pole posteriorly to pass the anastomosis and entering the ureter and urinary bladder, confirmed by observing methylene blue within the wound. The external end of the jj catheter was doubled up and sutured to the flank skin and then removed 4 weeks later. No procedure related complication(s) such as extravasation, infection, and stent displacement was seen. The duration of follow up was 6 months to 3 years. This method of stenting pyeloplasty is easily tolerated and causes no need for endoscopic removal of the catheter. It is an invaluable technique of pyeloplasty with stenting in very small children, and needs no external appliance.