Decreasing ureteral stent duration following radical cystectomy decreases readmissions and urinary infectious complications.
Decreasing ureteral stent duration following radical cystectomy decreases readmissions and urinary infectious complications.
366 Background: Readmission following Radical Cystectomy with Urinary Diversion (RCUD) is often related to Urinary Tract Infection (UTI). We hypothesized that decreasing the duration of ureteral stenting postoperatively would decrease UTI-related complications without affecting ureteroenteric stenosis (UES) rates. 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-January 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- POD 4). Statistical methods included t-test, chi-square test and multivariate logistic regression. Results: 177 patients were included in the final analysis after inclusion/exclusion criteria were applied. The LSR (n=75) and ESR (n=102) groups were similar in preoperative characteristics except higher intracorporeal ileal conduit formation in ESR. The LSR had higher 90-day overall readmission rates (OR=2.26, 95% CI;1.13,4.51, p-value=0.021), UTI-related readmissions (OR=3.05, 95% CI:1.32,7.04, p-value=0.010) and UAE (OR=3.02, 95%CI;1.47,6.18, p-value=0.003). Conclusions: Shorter ureteral stent duration following RCUD is associated with decreased readmissions and urinary infections complications without concurrent increase in UES. Strong consideration should be directed towards early stent removal. [Table: see text]
- Carolinas Medical Center United States
- Carolinas Healthcare System United States
- Levine Cancer Institute United States
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