Antegrade versus retrograde stenting in laparoscopic pyeloplasty

Purpose: To compare operative times between retrograde and antegrade ureteral stenting as part of laparoscopic pyeloplasty. Patients and Methods: Laparoscopic pyeloplasty procedures from January 2002 to January 2007 were identified through a prospective database. Procedures on 126 patients were performed using the same transperitoneal technique apart from the method of stent placement, which was performed in either a retrograde manner before laparoscopy or an antegrade manner during the laparoscopic portion of the procedure. Results: A total of 45 patients underwent antegrade stenting, 53 had retrograde stenting, 20 patients already had a stent in place, and 8 patients had retrograde pyelography followed by antegrade stenting. Operative time in patients with antegrade stent placement was significantly faster than in those with retrograde stent placement (median 185 v 245 min, P < 0.0001 [two-way analysis of variance]), even when the variability of the operative surgeon was taken into account. There was no difference in the complication rates. Conclusion: Antegrade stent placement results in a significantly faster overall operative time when compared with retrograde stent placement.