Ureteral stents do not cause bacterial infections in children after ureteral reimplantation

Urology. 2011 Jul;78(1):154-8. doi: 10.1016/j.urology.2010.11.016. Epub 2011 Jan 22.

Abstract

Objectives: To determine, in a prospective study, the incidence of bacterial colonization and the risk of bacterial infection of indwelling double-J stents in children undergoing ureteral reimplantation. In a balance between the safety and comfort of the child, the need for postoperative stenting of the reimplanted ureters has been discussed. It is unknown whether an indwelling double-J stent after ureteral reimplantation would be a risk factor for postoperative urinary tract infection.

Methods: From 2005 to 2010, 209 children (138 girls and 71 boys; median age 3.8 years) with vesicoureteral reflux underwent unilateral or bilateral cross-trigonal ureteral reimplantation (352 ureters). All children received a single dose of gentamicin (2 mg/kg body weight) and a preoperative bladder rinse with 10% polividone-saline solution. A transurethral catheter was also left postoperatively for 2 (unilateral) or 3 (bilateral) days. The ureter was stented with a 8-22 cm multilength catheter. At 3 weeks postoperatively, the ureteral catheters were removed and investigated for bacterial colonization.

Results: Of the 209 children, 10 (4.8%) developed a urinary tract infection within the first 6 weeks after ureteral reimplantation. Of the remaining 199 children without any symptoms, 13 (6.5%) had a positive urine culture at removal of the catheters. Of the 199 children without any symptoms, 90 (45.2%) had a positive culture of one or more segments of the double-J catheter.

Conclusions: Although the colonization rate of ureteral stents in our study was 42.9%, the rate of urinary tract infection during the first 6 weeks after ureteral reimplantation using indwelling ureteral stents was only 4.6%. We have concluded that the clinical significance of bacterial colonization of an indwelling ureteral stent is low, and therefore, ureteral stents can be used safely.

MeSH terms

  • Adolescent
  • Bacterial Infections / epidemiology
  • Bacterial Infections / etiology*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Incidence
  • Infant
  • Male
  • Prospective Studies
  • Prosthesis-Related Infections / epidemiology
  • Prosthesis-Related Infections / etiology*
  • Risk Factors
  • Stents / adverse effects*
  • Ureter / surgery*
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / etiology*
  • Urologic Surgical Procedures / methods
  • Vesico-Ureteral Reflux / surgery*