The outcome of stenting and its duration after pyeloplasty in children with ureteropelvic junction obstruction (UPJO): a systematic review and meta-analysis

• Published in: BMC urology Vol. 25; no. 1; pp. 227 - 10
• Main Authors: Wiratma, Made Kresna Yudhistira, Ghinorawa, Tanaya, Yuri, Prahara
• Format: Journal Article
• Language: English
• Published: London BioMed Central 03.09.2025; BioMed Central Ltd; BMC
• Subjects: Bladder; Case reports; Child; Children; Complications; Health aspects; Humans; Hydronephrosis; Implants; Infections; Internal Medicine; Kidney Pelvis - surgery; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Meta-analysis; Patients; Pediatric Patients; Pediatrics; Postoperative Complications - epidemiology; Pyeloplasty; Stent; Stent (Surgery); Stents; Stents - adverse effects; Surgery; Surgical outcomes; Systematic review; Time Factors; Treatment Outcome; Ureteral Obstruction - surgery; Ureteropelvic Junction Obstruction; Urinary incontinence; Urine; Urogenital system; Urologic Surgical Procedures - methods; Urology; Pediatric Patients; Ureteropelvic Junction Obstruction; Complications; Stent; Pyeloplasty
• ISSN: 1471-2490; 1471-2490
• DOI: 10.1186/s12894-025-01841-4

Background The complication related to the use of stent and its duration are still considered in the treatment option of UPJO despite the high success rates of several pyeloplasty techniques. Methods A systematic search was performed using PubMed/MEDLINE, ScienceDirect, and Cochrane databases, selecting cohort and controlled trial studies until April 2023. The following medical subject headings (MeSH) were included in the search: stent, ureteropelvic junction obstruction, pyeloplasty and children. Complication and success rate related to the stent placement after pyeloplasty were recorded. Results Eleven studies including 1072 patients were included. Eight studies compared stented versus non-stented pyeloplasty. Three studies compared 4-week stenting vs ≤ 2-week stenting. The total complication risk is decreased in stented group compared to non-stented group (OR 0.81, 95% CI 0.59–1.13). According to subgroup analysis, urinary leakage (OR 0.21 95% CI 0.10–0.47) and obstruction (OR 0.69 95% CI 0.32–1.47) are decreased in stented group. The total risk of complication is increased in 4-week stenting period (OR 5.11, 95% CI 2.43- 10.74) compared to ≤ 2-week stenting period, with the OR of each subgroup analysis is 4.64, 95% CI 1.8–11.97; 4.36, 95% CI 0.5–38.3 and 6.78, 95% CI 1.65–27.92 for fever, stent migration, and irritative symptom, respectively. There were no differences of success rate among the groups (OR 0.48, 95% CI 0.04–5.62). Conclusion The use of stent can reduce the risk of urinary leakage after pyeloplasty in children. Stenting duration ≤ 2 weeks carries a smaller risk of complications with the same post operative success rate as stents with a longer duration.