Illustration of a child's kidney showing the difference between Double-J stent and an externalized uretero-pyelostomy stent in pediatric pyeloplasty.

Pyeloplasty Showdown: Double-J Stents vs. Externalized Stents – Which Wins?

Soraya Malik in Health & Wellness December 2025 • 5 min read.

"Unveiling the Best Approach for Pediatric Kidney Drainage: A Comparative Analysis"

When it comes to pediatric urology, the health and well-being of our youngest patients are always the top priority. One common procedure, pyeloplasty, addresses a condition known as ureteropelvic junction (UPJ) obstruction, where the connection between the kidney and ureter is blocked. A critical aspect of this surgery involves drainage, and two primary methods have emerged: Double-J (DJ) internal stents and externalized uretero-pyelostomy (EUP) stents. This article dives deep into the comparative analysis of these two approaches, offering a comprehensive overview for parents and medical professionals alike.

The choice between DJ and EUP stents involves understanding the advantages and disadvantages of each. DJ stents, placed internally, have been a long-standing method, while EUP stents, which drain externally, offer a different set of considerations. This article aims to provide clarity on both, helping you grasp the essentials of each technique and their impacts on pediatric patients.

Our focus will be on a recent study that provides a comparative analysis of these two drainage techniques. By examining the surgical outcomes, complication rates, and overall effectiveness, we'll help you understand the nuances of each approach. This information is invaluable for anyone looking to gain insights into pediatric pyeloplasty and make informed decisions about the best care for children.

Double-J Stents vs. Externalized Stents: A Detailed Comparison

Illustration of a child's kidney showing the difference between Double-J stent and an externalized uretero-pyelostomy stent in pediatric pyeloplasty.

Both DJ and EUP stents play a crucial role in the success of pyeloplasty. DJ stents, placed internally, help keep the ureter open while the surgical site heals. They are typically removed in a second procedure. EUP stents, on the other hand, drain urine externally, offering an alternative method with its own set of considerations. Let's delve into a detailed comparison.

The recent study evaluated 76 children who underwent pyeloplasty. The primary focus was to compare the outcomes of those who received EUP stents versus those with DJ stents. The study examined various factors, including operative time, length of hospital stay, and the occurrence of complications. The results provide valuable data for understanding the efficacy and safety of each method.

Operative Time: The study found no significant difference in the time it took to perform the surgery between the two groups.
Length of Stay: The length of hospital stay was also similar, indicating that neither method resulted in a longer recovery period.
Complication Rates: The overall complication rates were comparable, suggesting that both methods are relatively safe.
Specific Complications: The study further analyzed the types of complications, differentiating between those occurring during surgery, shortly after, and later on. There were no significant differences in these subgroups.
Patient Demographics: EUP group patients were younger (40 ± 54 months) than DJ group patients (80 ± 78 months)
Surgical Approach: EUP group saw a greater proportion of open pyeloplasties, while DJ group more laparoscopic approaches.

These findings suggest that EUP stents are a safe and viable alternative to DJ stents. The study's conclusions highlight that EUP stents do not lead to increased operative time, longer hospital stays, or higher complication rates. While the study acknowledges some limitations, such as sample size, it provides valuable insights that can help guide clinical decisions and improve patient care.

Making Informed Choices in Pediatric Urology

The choice between Double-J stents and externalized stents in pediatric pyeloplasty is a complex one. This article provides a concise overview of the study's findings, highlighting the key differences between these methods. By understanding the pros and cons of each approach, medical professionals and parents can collaborate to make well-informed decisions. Continued research and clinical experience will further refine these techniques, leading to enhanced outcomes and a brighter future for children undergoing pyeloplasty. Always consult with a qualified urologist to determine the best course of action for your child's specific needs.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.5489/cuaj.2697, Alternate LINK

Title: Impact Of Drainage Technique On Pediatric Pyeloplasty: Comparative Analysis Of Externalized Uretero-Pyelostomy Versus Double-J Internal Stents

Subject: Urology

Journal: Canadian Urological Association Journal

Publisher: Canadian Urological Association Journal

Authors: Linda C. Lee, Niki Kanaroglou, Joseph M. Gleason, Joao L. Pippi Salle, Darius J. Bägli, Martin A. Koyle, Armando J. Lorenzo

Published: 2015-07-17

Everything You Need To Know

What is pyeloplasty and why might a child need it?

Pyeloplasty is a surgical procedure performed to correct a ureteropelvic junction (UPJ) obstruction, which is a blockage where the ureter connects to the kidney. This blockage can prevent urine from draining properly, potentially damaging the kidney. Children may need pyeloplasty to relieve this obstruction and restore normal kidney function. Drainage of the kidney after pyeloplasty is done using either Double-J stents or externalized uretero-pyelostomy stents.

What are Double-J (DJ) stents and how do they aid in pediatric pyeloplasty?

Double-J (DJ) stents are internal tubes placed during pyeloplasty to keep the ureter open while the surgical site heals. They facilitate urine flow from the kidney to the bladder, preventing complications such as strictures or blockages during the healing process. Typically, a second procedure is required to remove the Double-J stents once healing is complete. The article mentions that the Double-J stent group had a greater proportion of laparoscopic approaches compared to the externalized uretero-pyelostomy stent group.

What are externalized uretero-pyelostomy (EUP) stents, and what are their considerations compared to Double-J stents in pediatric pyeloplasty?

Externalized uretero-pyelostomy (EUP) stents are drainage tubes that, unlike Double-J stents, drain urine externally from the body after pyeloplasty. Considerations include the need for external management of the drainage and monitoring for potential site infections, but they offer an alternative to internal drainage. The article found that patients who received EUP stents tended to be younger than those who received Double-J stents, with the EUP group seeing a greater proportion of open pyeloplasties.

According to the study, what are the key differences in outcomes between using Double-J stents and externalized uretero-pyelostomy stents in pediatric pyeloplasty regarding operative time, hospital stay, and complication rates?

The study found no significant differences in operative time, length of hospital stay, or overall complication rates between using Double-J stents and externalized uretero-pyelostomy stents in pediatric pyeloplasty. This suggests that both methods are relatively safe and effective. Specific analysis of different types of complications (during surgery, shortly after, and later on) also showed no significant differences between the two groups. This data suggests externalized uretero-pyelostomy stents are a viable alternative to Double-J stents. Future considerations not mentioned include cost analysis and long-term follow-up studies.

What are the implications of the finding that patient demographics and surgical approach differ between the Double-J stent and externalized uretero-pyelostomy stent groups, and how might these differences influence treatment decisions?

The study indicated that patients in the externalized uretero-pyelostomy (EUP) stent group were younger (40 ± 54 months) compared to those in the Double-J (DJ) stent group (80 ± 78 months). Additionally, a greater proportion of open pyeloplasties were performed in the EUP group, while laparoscopic approaches were more common in the DJ group. These differences suggest that surgeons may be tailoring their choice of stent and surgical approach based on patient age or other factors influencing surgical suitability. This highlights the importance of considering individual patient characteristics when determining the optimal drainage method and surgical technique for pediatric pyeloplasty. Further research is needed to explore the reasons behind these associations and to determine whether specific patient subgroups benefit more from one approach over the other.