Benefits and Complications of Removing Ureteral Stent Based on the Elapsed Time After Renal Transplantation Surgery

Abstract

BackgroundThe most important surgical complications of renal transplantation are stenosis and obstruction of anastomosis of the ureter to the bladder. Although the routine use of the ureteral stents to prevent such complications seems rational, the optimal time to keep the ureteral stent is still controversial.ObjectivesThis study presents the benefits and complications of removing the ureteral stent based on the elapsed time after the surgery.Patients and MethodsAll patients who underwent kidney transplantation between May 2011 and August 2014 in Modarres hospital, Tehran, Iran, were enrolled in the study. The patients were classified into three groups. The ureteral stent was removed 10, 20, and 30 days after the transplantation in these groups.ResultsA total of 529 patients underwent kidney transplant surgery in our center. Urologic complications among the three groups consisting of hydronephrosis, urinoma and collection did not have statistically significant differences.ConclusionsUreteral stent can be picked up with no increased risk of urologic complications at shorter intervals after the kidney transplantation surgery.

Timing of Ureteric Stent Removal and Occurrence of Urological Complications after Kidney Transplantation: A Systematic Review and Meta-Analysis

“…Of the 1043 articles identified from the initial literature search, fourteen articles were within the scope of this systematic review; three randomised controlled trials (RCTs) [20,21,31], nine retrospective cohort studies [8,13,19,22,23,32,33,34,35] and two prospective studies [36,37]. A total of 3216 patients were included, of which 2406 patients (74.8%) underwent living donor KTx (two studies did not record if they used living or deceased donors [34,35]).…”

“…We could not specify the type of stent in five studies. The authors of these five papers were contacted, but unfortunately, we received no response [19,34,35,36,37]. All studies reported the age of the recipients, except for the preliminary results in the three included abstracts [34,35,36].…”

“…All studies reported the age of the recipients, except for the preliminary results in the three included abstracts [34,35,36]. Only four studies reported that they both included adults and children [19,21,23,37]. All articles described the incidence of UTIs, and nine articles also reported urinary leakage and/or ureteral stenosis [19,20,21,31,32,33,35,36,37].…”

“…Regarding the used UNC technique, seven out of the fourteen articles described the use of the Lich–Gregoir technique [13,20,21,22,23,31,32]. Seven articles did not specify which surgical technique was used [8,19,33,34,35,36,37]. Regarding stent removal, ten articles used a cystoscopy for removal [8,20,21,22,23,32,33,34,35,36].…”

“…Two studies removed the stent on the seventh day posttransplant by pulling on strings that were placed around the stent at the time of transplantation [8,20]. Four studies did not describe the technique of stent removal [13,31,37,38]. Ten studies reported the use of antibiotic prophylaxis to protect against UTI after KTx, of which seven studies also reported the duration of antibiotic prophylaxis regimen [13,20,21,23,31,32,33].…”