J Korean Soc Transplant.  2003 Dec;17(2):176-180.

Impact of the Routine Double-J Ureteral Stent Placement for Renal Transplantation

• Joo SH
• Kim JS
• Lee S

Abstract

INTRODUCTION
The majority of urological complications in renal transplantations are related to ureterovesical anastomosis and urological complications continue to be a significant source of morbidity with occasional graft loss and mortality. PURPOSE: We evaluated the impact of the routine placement of double-J ureteral stent for decreasing urological complications after renal transplantation.
METHODS
A retrospective study was conducted involving 80 consecutive cadaveric and living donor renal transplantations performed between January 1999 and March 2003. All patients were divided in two groups: stented versus non-stented. The ureteroneocystostomy was made by anterior extravesical technique in all cases as Lich et al described. The stent was removed endoscopically after 2 to 4 weeks after transplantation if there were no surgical problems. All episodes of urinary tract infection, urinary leaks, urinary stricture, prolonged discharge by suction drain, hospital day and stent related problems were analysed.
RESULTS
The overall major surgical complication rates in non-stented and stented groups were 5.9% (3 of 51) and 3.4% (1 of 29), respectively. In non-stented group, two ureteral leakages and one ureteral stricture developed. Two ureteral leakages were required reoperation in immediate postoperative period. But only one patient in stented group had symptomatic lymphocele requiring surgical correction (laparoscopic fenestration).Hospital stay was much shorter in stented group (23.0+/-5.4 days vs 31.3+/-9.3 days; P<.05). The timing of removal of suction drain is much faster in stented group (11.1+/-6.7 days vs 22.8+/-8.0 days; P<.05). There was no case of stent-related obstruction, stone formation and stent migration. There was no graft loss or mortality due to urological complications.
CONCLUSION
The routine use of a double-J stent is recommendable in all recipients in order to prevent ureteral complications after renal transplantation.

Keyword

Double-J ureteral stent; Urinary leakage; Renal transplantation

MeSH Terms

Cadaver
Constriction, Pathologic
Humans
Kidney Transplantation*
Living Donors
Lymphocele
Mortality
Postoperative Period
Reoperation
Retrospective Studies
Stents*
Suction
Transplants
Ureter*
Urinary Tract Infections