SHORTER STENT DURATION IN PATIENTS UNDERGOING RADICAL CYSTECTOMY IS FEASIBLE AND SAFE

Abdul Baseet Arham; Mohamad Abou Chakra; Sarah L Mott; Vignesh T Packiam; Michael A O'Donnell

doi:10.1016/j.urolonc.2024.12.245

For patients undergoing radical cystectomy, conventional practice has been outpatient removal of ureteral stents on post-operative day (POD) 10-14. We aimed to determine whether shorter stent duration resulted in different urinary complications in the short term (stent-related symptoms, urine leak, UTI) or long-term (readmission, anastomotic strictures). A retrospective review of patients records from the University of Iowa identified 179 patients who underwent radical cystectomy for bladder cancer. Patient were stratified in two groups based on stent type: 90 patients had 7 French mono J stents with conventional duration (10-14 days), 89 patients had 5 French feeding tubes and shorter duration (4-5 days). Stent duration, stent related symptoms, urine leak, symptomatic UTI, length of stay, surgical site infection, 30- and 90-days readmission rates, and ureteroenteric anastomotic stricture rate were measured. Chi-squared or Fisher's exact tests (where appropriate) were used to compare categorical variables, and Wilcoxon rank sum tests were used to compare continuous variables between groups. The median age of patients for the mono J group was 72 years (IQR 64-77) and 70 years (IQR 63-78) for the feeding tube group (Table 1). Patients receiving a mono J stent had longer median duration of stent versus those receiving feeding tubes (15 vs 5 days, p<0.01, respectively). There was a numerical difference in the rate of stent related symptoms (15.6% vs 6.7%, p=0.06) in patients who received mono J versus feeding tubes, respectively. There were no significant differences in urinary complications between those who underwent mono J versus feeding tubes, with regard to urinary leakage (2.2% vs 1.1%), symptomatic UTIs (32.2% vs 22.7%), 30 day (23.3% vs 13.5%) and 90 day (34.4% vs 23.6%) readmission rates, and ureteroileal stricture (4.4% vs 2.2%), respectively. There were similar urinary complications in patients who underwent shorter stent duration, supporting surgeon preference for this practice. Further prospective studies are warranted.

SHORTER STENT DURATION IN PATIENTS UNDERGOING RADICAL CYSTECTOMY IS FEASIBLE AND SAFE

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