A Comparative Analysis of Double-J Stent and Nephrostomy With a Transanastomotic Stent in Open Pyeloplasty for Pelviureteric Junction Obstruction in Children: A Prospective Observational Study

Background This study aims to compare the outcomes of double-J (DJ) stenting versus nephrostomy with transanastomotic (NTA) stenting in children undergoing open pyeloplasty, focusing on operative time, complications, postoperative pain, hospital stay, cost-effectiveness, and caregiver satisfaction. Methodology A prospective, observational study was conducted on 30 children who underwent open pyeloplasty between January 2023 and June 2024. Intraoperative and postoperative parameters were analyzed, including postoperative pain, complications, hospital stay, treatment cost, caregiver satisfaction scores, and postoperative renal function at the six-month follow-up. Results The DJ stent group (Group A) had a significantly shorter operative time (118 minutes vs. 160 minutes, p = 0.0001), lower postoperative pain from 24 to 72 hours (p < 0.05), and higher caregiver satisfaction (8.76 vs. 6.56, p = 0.001). Although the NTA group (Group B) experienced fewer complications, the difference was insignificant (p = 0.45). However, NTA stents were easier to remove (not requiring a second anesthesia) and were more cost-effective (p < 0.0001). No significant difference was observed in postoperative renal function between the groups. Conclusions This study highlights that DJ stenting offers better pain control, shorter hospital stay, and higher caregiver satisfaction. NTA stenting may be considered in specific scenarios such as failed DJ stent placement, financial constraints, or large hydronephrotic kidneys where nephropexy is advantageous.