Stented versus stentless pyeloplasty in adults: A systematic review of surgical outcomes and complications.

Introduction: Ureteropelvic junction obstruction causes upper urinary tract obstruction, resulting in pain, infections, and renal impairment. Pyeloplasty with Double-J stents is the standard treatment, but stents cause significant morbidity. Stentless approaches may reduce symptoms while maintaining...

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Publicado en:Indian Journal of Urology Vol. 42; no. 1; pp. 6 - 16
Autores principales: Mittal, Ankur, Subramanyam, Anumanchi Dattasai, Panwar, Vikas Kumar, Singh, Deelip Kumar, Agrawal, Omang
Formato: research systematic review tables/charts Journal Article
Publicado: Wolters Kluwer India Pvt Ltd Jan-Mar2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan-Mar2026
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        atl: Stented versus stentless pyeloplasty in adults: A systematic review of surgical outcomes and complications.
      aug:
        au:
          Mittal, Ankur
          Subramanyam, Anumanchi Dattasai
          Panwar, Vikas Kumar
          Singh, Deelip Kumar
          Agrawal, Omang
        affil: Department of Urology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
      sug:
        subj:
          Stents Utilization
          Ureteral Obstruction Surgery
          Surgery, Urogenital Methods
          Postoperative Complications
          Treatment Outcomes Evaluation
          Human
          Systematic Review
          Male
          Female
          Adult
          PubMed
          Embase
          Cochrane Library
          Urination
          Ureteral Obstruction Radiography
          Nuclear Medicine
          Reoperation
          Postoperative Complications Risk Factors
          Risk Assessment
          Anastomosis, Surgical
          Length of Stay
          Fibrin Tissue Adhesive
          Kidney Physiology
          Glomerular Filtration Rate Evaluation
          Checklists
          Descriptive Statistics
          Data Analysis Software
          Adult: 19-44 years
          Male
          Female
      ab: Introduction: Ureteropelvic junction obstruction causes upper urinary tract obstruction, resulting in pain, infections, and renal impairment. Pyeloplasty with Double-J stents is the standard treatment, but stents cause significant morbidity. Stentless approaches may reduce symptoms while maintaining efficacy. Methods: Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 guidelines (International Prospective Register of Systematic Reviews: CRD42025643943). PubMed, Embase, and Cochrane were searched through March 2025. "Studies comparing stented versus stentless pyeloplasty in adults (≥18 years) were included". Primary outcomes were surgical success and complications. Secondary outcomes included urinary leakage, reintervention, and hospital stay. Narrative synthesis was performed due to heterogeneity. Results: Ten studies encompassing 5820 patients were included, comprising one randomized controlled trial, four prospective, and five retrospective studies. Success rates ranged from 66.7% to 100% for stented procedures and 88%–100% for stentless approaches, with no significant difference in most studies. Stented patients experienced higher rates of lower urinary tract symptoms (64.7%–100%) compared to stentless groups (0%–3.8%), as well as hematuria (27%–95.4%) versus 0%–4.3%, with variable urinary tract infection rates. Stentless groups showed increased urinary leakage up to 24%, though mostly self-limited. Twenty-three stentless patients required secondary stenting, while thirteen stented patients needed reintervention for stricture or complications. Conclusions: Stentless pyeloplasty is effective in selected adults, significantly reducing stent-related morbidity without compromising success rates when performed with meticulous technique and appropriate patient selection.
      pubtype: Academic Journal
      doctype:
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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