Moderated Poster Session
MP14-3 - Trends and patterns of ureteral stent indwelling after adult pyeloplasty in the United States: A Nationwide Population-based Analysis
Saturday, September 22
10:00 AM - 12:00 PM
Location: Room 241
Deok Hyun Han, MD PhD
Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine
Kyung Jin Chung
Department of Urology, Gachon University Gil Hospital
Jae Heon Kim
Department of Urology, Soon Chun Hyang University Seoul Hospital, Soon Chun Hyang University College of Medicine
Introduction & Objective : Ureteral stent is routinely placed after pyeloplasty for the treatment of ureteropelvic junction obstruction in adults. However, little is known about the stent placement time after pyeloplasty in real practice. We examined the trend of indwelling time of ureteral stent after pyeloplasty through a nationwide population-based data.
Methods : We performed a retrospective cohort study in adults who underwent pyeloplasty from 2007 to 2015 by using the Truven Health MarketScan database. Patients who are 18 years old or higher, who had both CPT codes of pyeloplasty (50400, 50405, 50544) and ureteral stent removal after pyeloplasty were included. Trends of ureteral stent indwelling time were investigated and clinical factors that affected stent indwelling time were evaluated by using Log-rank test and Cox proportional hazard model.
Results : A total of 4,997 patients were included in this study. The mean age was 31.5 years, and M/F ratio was 0.98. Charlson comorbidity index (CCI) was 0 or 1 in 82.3% and 2 or greater in 17.7%. Open pyeloplasty was performed in 34.1%, and laparoscopic (including robot-assisted) pyeloplasty was done in 65.9%. Primary pyeloplasty was in 91.6%, and salvage pyeloplasty was in 8.4%. Most patients (89.2%) had ureteral stents for 8 weeks or shorter. Most common stent indwelling time group was ‘5<and≤6 weeks’ (21.6%) followed by ‘4<and≤5 weeks' (20.8%), and ‘6<and≤7 weeks' (20.0%).
Stent indwelling time was significantly shorter in laparoscopic pyeloplasty group than open group (5.4 vs. 5.9 weeks, HR 1.24 (95% CI 1.16-1.31)) and primary group than salvage group (5.6 vs. 6.0 weeks, HR 1.24 (95% CI 1.12-1.37)). Patients with shorter hospital stay, lower CCI, younger age, and female gender had significant shorter stent indwelling time.
Conclusions : In real practice, ureteral stent indwelling time after pyeloplasty was varied in the United States. And there was no significant difference in indwelling time of ureteral stent over time. Patients with primary pyeloplasty and minimally invasive pyeloplasty had shorter stent indwelling time.