Pd21-11 Reducing Infectious Complications With Omission of Ureteral Stents During Robotic Cystectomy With Intracorporeal Ileal Conduit

You have accessJournal of UrologyReconstruction: Augmentation, Substitution, Diversion (PD21)1 May 2024PD21-11 REDUCING INFECTIOUS COMPLICATIONS WITH OMISSION OF URETERAL STENTS DURING ROBOTIC CYSTECTOMY WITH INTRACORPOREAL ILEAL CONDUIT Jacob E. Tallman, Emily A. Vertosick, Syed M. Alam, Fady J. Baky, S. Machele Donat, Bernard H. Bochner, Eugene J. Pietzak, and Alvin C. Goh Jacob E. TallmanJacob E. Tallman , Emily A. VertosickEmily A. Vertosick , Syed M. AlamSyed M. Alam , Fady J. BakyFady J. Baky , S. Machele DonatS. Machele Donat , Bernard H. BochnerBernard H. Bochner , Eugene J. PietzakEugene J. Pietzak , and Alvin C. GohAlvin C. Goh View All Author Informationhttps://doi.org/10.1097/01.JU.0001008888.07102.14.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: While ureteral stents have been hypothesized to decrease ureteroenteric anastomosis (UEA) complications during urinary diversion, prior studies of open cystectomy report conflicting data. We evaluated the association between intraoperative stent use and UEA complications in a contemporary cohort of patients undergoing robotic assisted radical cystectomy with intracorporeal ileal conduit (RARC-IC). METHODS: We reviewed a prospective database of patients at our institution who underwent RARC-IC from 2017-2023, comparing outcomes by stent use. Stents were routinely omitted during RARC-IC starting August 2021 and could be placed at surgeon's discretion. Our primary outcome of interest was UEA-related complications within 30 days of RARC-IC, including urine leak, urinary tract infection (UTI), intra-abdominal abscess, or sepsis. Secondary outcomes included wound infections, urgent care (UCC) visit and readmission rates, and ureteral strictures. RESULTS: 133 patients were included, 90 (68%) received stents and 43 (32%) did not. There were no significant differences in clinical or demographic characteristics (Table 1). At 30 days, we observed a UEA complication in 18 (20%) patients in the stent group and 4 (9%) patients with no stent (11% difference, 95% CI -3.0% -24%, p=0.2, Table 2). There was a significantly higher UTI rate in the stent group (19% difference, 95% CI 19% -29%, p=0.006). Rates of wound infection, UCC visits, and readmissions were higher among stented patients, though not statistically significant. There were 2 urine leaks, both occurring in the no stent group. Among 93 patients that had at least 6-month follow-up, there were 4 who developed a ureteral stricture, 3 in the stent group and 1 in the no stent group. CONCLUSIONS: In a single center review of patients RARC-IC, we observed decreased UEA complications and readmissions among unstented patients. Omission of ureteral stent placement at RARC-IC appears safe and feasible, warranting further prospective investigation. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e458 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Jacob E. Tallman More articles by this author Emily A. Vertosick More articles by this author Syed M. Alam More articles by this author Fady J. Baky More articles by this author S. Machele Donat More articles by this author Bernard H. Bochner More articles by this author Eugene J. Pietzak More articles by this author Alvin C. Goh More articles by this author Expand All Advertisement PDF downloadLoading ...