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. 2012 Jul;22(4):275-9.
doi: 10.4103/0971-4065.101247.

Is early removal of prophylactic ureteric stents beneficial in live donor renal transplantation?

K N Indu  1 , G Lakshminarayana, M Anil, R Rajesh, K George, K Ginil, M Georgy, B Nair, S Sudhindran, T Appu, V N Unni, K V Sanjeevan
Affiliations

Is early removal of prophylactic ureteric stents beneficial in live donor renal transplantation?

K N Indu et al. Indian J Nephrol. 2012 Jul.

Abstract

Prophylactic ureteric stenting has been shown to reduce ureteric leaks and collecting system obstruction following renal transplantation and is in widespread use. However, the optimal time for removal of ureteric stents after renal transplantation remains unclear. Aim of this study was to compare the result of early versus late removal of ureteric stents after kidney transplantation of the laparoscopically retrieved live related donor grafts. Eligible patients were live donor kidney transplant recipients with normal urinary tracts. All recipients underwent extravesical Lich-Gregoire ureteroneocystostomy over 4F/160 cm polyurethane double J stents by a uniform technique. They were randomized on seventh postoperative day for early removal of stents on postoperative day 7 (Group I), or for late removal on postoperative day 28 (Group II). The incidence of urinary tract infections, asymptomatic bacteriuria, and urological complications were compared. Between 2007 and 2009, 130 kidney transplants were performed at one centre of which 100 were enrolled for the study, and 50 each were randomized into the two groups. Donor and recipient age, sex, native renal disease, immunosupression, number of rejection episodes, and antirejection therapy were similar in the two groups. The occurrence of symptomatic urinary tract infection during the follow-up period of 6 months was significantly less in the early stent removal group [5 out of 50 (10%) in Group I, vs 50 out of 15 (30%) in Group II, P=0.02]. Asymptomatic bacteriuria was documented in 2 out of 50 (4%) in Group I and 4 out of 50 (8%) in Group II (P=0.3). There was no statistically significant difference in the rate of ureteric leak, ureteric obstruction, or hematuria in the two groups (P=1.0). We conclude that, in kidney transplant recipients of laparoscopically retrieved live donor grafts, early stent removal at the end of first week reduces the incidence of urinary tract infection without increasing the rate of urine leak or ureteric obstruction.

Keywords: Renal transplantation; ureteric leak; ureteric stenting; urinary tract infections.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Incidence of urinary tract infections (UTI) (early (Group I) vs late (Group II) removal of ureteric stent). P value=0.02
Figure 2
Figure 2
Organisms causing urinary tract infections
See this image and copyright information in PMC

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