The Watertightness of the Anastomosis After Laparoscopic or Robot-Assisted Pyeloplasty: Is a Drainage Necessary?

Abstract Objective: To determine whether or not temporary drainage is necessary immediately following laparoscopic (lap) and robot-assisted (rob) pyeloplasty (PP). Patients and Methods: Of 99 patients undergoing lap PP (n = 23) or rob PP (n = 76) for treatment of ureteropelvic junction obstruction (UPJO), 52 had no drainage, 47 were given an “easy-flow” drain (EFD). The volume of leaking urine (in mL) was defined as the volume of drainage fluid (in mL) × creatinine concentration in drainage fluid (in μmol/mL)/median urine creatinine concentration (in μmol/mL). An anastomosis was considered to be leaking if the volume of leaking urine exceeded 5 mL/24 hours. During follow-up the PP success rate was evaluated based on clinical symptoms, intravenous urography and diuretic renography for detection of persisting obstruction. Results: Median creatinine concentration in drainage fluid was 90 μmol/L (range 44–6270 μmol/L) in a median volume of 84 mL (range 5–1400 mL) drained fluid in 24 hours. The median leaking ...