Evaluation of Ureteral Stent Colonization in Live-Donor Renal Transplant Recipients

Sarıer, Mehmet; Demir, Meltem; Duman, İbrahim; Yüksel, Yücel; Demirbaş, A.

doi:10.1016/j.transproceed.2017.01.004

Cited by 21 publications

(21 citation statements)

References 23 publications

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“…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]).…”

Section: Resultsmentioning

confidence: 99%

“…Table 2 presents the incidence of the different outcome parameters for each study. 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].…”

Section: Resultsmentioning

confidence: 99%

“…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]. In four studies, the stent was removed along with the urinary catheter seven days after transplantation [21,34,35,36].…”

Section: Resultsmentioning

confidence: 99%

“…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]. Six studies specified the use of co-trimoxazole as prophylaxis [13,21,22,23,31,32]. Four studies did not record the use of prophylactic antibiotics at all [8,36,37,38].…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, the guideline advises stents to be removed earlier than six weeks post-transplant (which is protocol in most transplant centres) rather than later. Therefore, in the last two years, studies have started to investigate different timings of stent removal within one-month post-transplant [8,18,19,20,21,22,23]. Recently, Thompson et al [24] published a review regarding this topic; however, the authors included fewer studies and did provide a robust conclusion about timing of stent removal as their focus was more on the difference between per-urethral and bladder indwelling stents.…”

Section: Introductionmentioning

confidence: 99%

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

Visser

Staaij

Muthusamy

et al. 2019

JCM

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Implanting a ureteric stent during ureteroneocystostomy reduces the risk of leakage and ureteral stenosis after kidney transplantation (KTx), but it may also predispose to urinary tract infections (UTIs). The aim of this study is to determine the optimal timing for ureteric stent removal after KTx. Searches were performed in EMBASE, MEDLINE Ovid, Cochrane CENTRAL, Web of Science, and Google Scholar (until November 2017). For this systematic review, all aspects of the Cochrane Handbook for Interventional Systematic Reviews were followed and it was written based on the PRISMA-statement. Articles discussing JJ-stents (double-J stents) and their time of removal in relation to outcomes, UTIs, urinary leakage, ureteral stenosis or reintervention were included. One-thousand-and-forty-three articles were identified, of which fourteen articles (three randomised controlled trials, nine retrospective cohort studies, and two prospective cohort studies) were included (describing in total n = 3612 patients). Meta-analysis using random effect models showed a significant reduction of UTIs when stents were removed earlier than three weeks (OR 0.49, CI 95%, 0.33 to 0.75, p = 0.0009). Regarding incidence of urinary leakage, there was no significant difference between early (<3 weeks) and late stent removal (>3 weeks) (OR 0.60, CI 95%, 0.29 to 1.23, p = 0.16). Based on our results, earlier stent removal (<3 weeks) was associated with a decreased incidence of UTIs and did not show a higher incidence of urinary leakage compared to later removal (>3 weeks). We recommend that the routine removal of ureteric stents implanted during KTx should be performed around three weeks post-operatively.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

Visser

Staaij

Muthusamy

et al. 2019

JCM

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Design and characterization of a novel braided biodegradable double‐J ureteral stent

Cui

Zhang

Gao

et al. 2022

Polymers for Advanced Techs

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Ureteral stents in current clinical use are non-degradable and have a large degree of curling at the ends. This end curling can cause discomfort to patients as well as renal or bladder irritation. In this study, a braided degradable ureteral stent was designed and characterized to eliminate these problems. Eight-, 12-, and 16-strand poly(lactide-co-ε-caprolactone) (PLCL) monofilament-braided degradable ureteral stents were prepared, and their tensile performance, radial support performance, in vitro degradation, fixation performance, bending resistance performance, and drainage performance were tested. Compared with the commonly used polyurethane (PU) stent, the tensile strengths of the three types of PLCL stents were higher, with the 12-strand monofilament-braided stent exhibiting the highest tensile strength ($508.06 MPa). In terms of radial support, the three PLCL stents meet clinical requirements. After repeated crimping-rebounding of the braided stent, the support force recovery rate of the 12-strand monofilament-braided stent was the best, reaching 92%. In vitro degradation results showed that the 12-strand stent still maintained good radial support after 8 weeks. The fixation strength of a 12-strand monofilament-braided stent with a single loop on the J-shaped end meets clinical requirements. Even after repeated bending, the 12-strand monofilament-braided stent can maintain the stability of the structure with excellent drainage performance.

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Comprehensive analysis of the bacterial spectrum for enhanced clinical insight in microbial ureteral stent colonization, uncomplicated urinary tract infections and catheter-associated urinary tract infections: a principal component analysis-based literature review

Lepori,

Braissant,

Bonkat

et al. 2024

World J Urol

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Purpose Controversies exist regarding the prevailing spectrum of microorganisms in microbial ureteral stent colonization (MUSC) and their clinical significance. The aim of this comprehensive review is to determine the predominant microbial spectrum in patients with an indwelling ureteral stent in comparison to catheter-associated urinary tract infections (CAUTI) and uncomplicated urinary tract infections (UTI). Methods Google scholar, PubMed, Embase, Medline, and Cochrane literature databases were searched from inception to April 2022 to identify manuscripts on MUSC, uncomplicated UTI and CAUTI. A principal component analysis (PCA) was performed to identify patterns of the pathogen spectrum of the different groups. Results We included 29 studies on MUSC, 28 studies on uncomplicated UTI and 23 CAUTI studies. The proportion of Staphylococci, Enterococci and Candida were significantly higher in MUSC and stent associated bacteriuria compared to their proportion in uncomplicated UTIs where E. coli dominates. By comparing MUSC, CAUTI and UTI with a PCA, the detected pathogen spectrum exhibited clearly distinguishable trends in the frequency of the main isolated pathogens influencing these three groups of urinary tract infections. With respect to MUSC and UTI, their 95% confidence interval ellipse only showed minimal overlap emphasizing that the spectrum of pathogens in the two groups is clearly distinct. Conclusions The frequency of detection of Staphylococci, Enterococci and Candida is more common in MUSC as compared to UTI. Thus, patients with indwelling ureteral stents should undergo an antimicrobial prophylaxis targeting this microbial spectrum in case of further surgery.

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Evaluation of Ureteral Stent Colonization in Live-Donor Renal Transplant Recipients

Cited by 21 publications

References 23 publications

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

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

Design and characterization of a novel braided biodegradable double‐J ureteral stent

Comprehensive analysis of the bacterial spectrum for enhanced clinical insight in microbial ureteral stent colonization, uncomplicated urinary tract infections and catheter-associated urinary tract infections: a principal component analysis-based literature review

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