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Safety of decreasing ureteral stent duration following radical cystectomy

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World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

We aim to assess the safety of decreasing ureteral stenting duration following Radical Cystectomy with Urinary Diversion (RCUD).

Materials and methods

We analyzed a prospectively and retrospectively collected dataset for cystectomy patients at our tertiary center. Adult patient who underwent RCUD for malignancy from January 2013 to February 2018 were included. Patients with a history of abdominal/pelvic radiation and continent diversions were excluded. The patient population was divided to late stent removal group (LSR-POD 14) and early stent removal group (ESR-POD5). Our endpoints were total stent duration, 90-day readmission, 90-day total-UTI, 90-day urinary-readmissions, complications and Ureteroenteric Stricture (UES) rates. Statistical methods included t test, Chi-squared test and multivariate logistic regression.

Results

One hundred and seventy-eight patients were included in the final analysis after inclusion/exclusion criteria were applied. The LSR (n = 74) and ESR (n = 104) groups were similar in preoperative characteristics except higher intracorporeal ileal conduit formation in ESR. The duration of stenting decreased significantly from approximately 15.5–5 days (P < 0.001). The LSR had higher 90-day overall readmission rates (OR = 2.57, 95% CI 1.19–5.53, P = 0.016) and total-UTIs (OR = 2.36, 95%CI 1.11–5.04, P = 0.026). With a median follow-up of 9.8 months, UES was similar between the two groups.

Conclusion

Shorter ureteral stent duration is a safe and non-inferior option following RCUD. It allows for stent removal prior to discharge and less outpatient visits. In addition, decreasing stent duration was linked decreased readmissions and total-UTIs without increased risk of UES. However, future studies are needed to establish causality and promote stent duration change.

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Acknowledgements

We will want to acknowledge the Salvino Family and Don and Better Anderson for their support.

Funding

This study has no external funding.

Author information

Authors and Affiliations

  1. Department of Urology, Carolinas Medical Center/Atrium Health, 1000 Blythe Ave, Suite 163, Medical Education Building, Charlotte, NC, 28203, USA

    Hamza Beano, William Worrilow, William Townsend, Kris Gaston, Peter E. Clark & Stephen Riggs

  2. Department of Cancer Biostatistics, Levine Cancer Institute/Atrium Health, Charlotte, USA

    Jiaxian He & Caitlin Hensel

Authors
  1. Hamza Beano
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  2. Jiaxian He
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  3. Caitlin Hensel
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  4. William Worrilow
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  5. William Townsend
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  6. Kris Gaston
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  7. Peter E. Clark
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  8. Stephen Riggs
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Contributions

HB: Project development, Data collection and management, Data analysis, Manuscript writing and editing. JH: Data analysis, Manuscript writing and editing. CH: Project development, Data collection and management, Manuscript writing and editing. WW: Data collection and management, Manuscript writing and editing. WBT: Project development, Manuscript writing and editing. KG: Project development, Manuscript writing and editing. PEC: Manuscript writing and editing. SBR: Project development, data collection and management, Data analysis, Manuscript writing and editing.

Corresponding author

Correspondence to Hamza Beano.

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Conflict of interest

Author SB Riggs is a consultant for C-SATS and is a shareholder in Exelixis and ESSA pharmaceuticals. The remaining authors declare that they have no conflict of interest.

Informed consent

No identifying information was used in preparing this project. Per institutional and national guidelines, no extra informed consent documentation was required.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional national research committee at Carolinas Medical Center/Levine Cancer Institute and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Given that this was a retrospective review of a cystectomy dataset, a separate IRB approval was not required by the institutional or national standards.

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Beano, H., He, J., Hensel, C. et al. Safety of decreasing ureteral stent duration following radical cystectomy. World J Urol 39, 473–479 (2021). https://doi.org/10.1007/s00345-020-03191-2

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  • DOI: https://doi.org/10.1007/s00345-020-03191-2

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