Should transplant ureter be stented routinely or not?

OBJECTIVE

To compare early complications in patients with/without stents following renal transplantation and to determine whether routine stenting should be used in all renal transplant patients or not.

METHODS

194 patients (108 males, 86 females, mean age: 45.2 ± 13.2 years) who were followed-up at the Division of Nephrology of Istanbul Bilim University between 2006 and 2013 were included in the study. Demographic characteristics, etiologies of renal disease, comorbidities, type of renal transplantation, early complications, delayed graft function were retrospectively recorded. All patients were divided into two groups according to stent replacement. Early complications were compared.

RESULTS

101 patients were inserted double-J(DJ) stent (48 females, mean age 46.5 ± 13.7 years, mean body mass index [BMI] 26.1 ± 4.7 kg/m²) and 93 patients were not inserted stent (38 females, mean age 43.7 ± 12.6 years, mean BMI 24.3 ± 4.2 kg/m²). The rate of early complications of urinary tract infections, lymphocele, urinary leaks, wound infection and perirenal hemorrhage of patients with stent were 28.9%,3.0%,4.0%, 5.1% and 1.3%, respectively, while these rates among patients without stent were 35.5%, 2.2%,3.2%,6.5% and 1.2%,respectively. There was no significant difference between with stent and without stent groups with regard to early complications.

CONCLUSIONS

Routine DJ stenting in all renal transplant patients is not necessary. Prophylactic use of DJ stent has no effect on early complications. Prophylactic DJ stent replacement can be used in obese patients, in patients receiving cadaveric transplants or in patients receiving transplants from unrelated donors.