External Ureteric Stent Versus Internal Double J Stent in Kidney Transplantation: a Retrospective Analysis on the Incidence of Urological Complications and Urinary Tract Infections

Overview

Journal Front Nephrol

Specialty Nephrology

Date 2023 Sep 7

PMID 37675367

Authors

Ietje T Hazenberg

Stephanie J M Middelkoop

Anoek A E de Joode

Juliette D Rabbeljee

Robert A Pol

Benjamin H J Doornweerd

Jan-Stephan F Sanders

Coen A Stegeman

Affiliations

Soon will be listed here.

Abstract

Introduction: Urologic complications (UCs) and urinary tract infections (UTIs) are common after kidney transplantation. Intraoperative stent placement at the vesicoureteric anastomosis reduces UC risk, but increases UTI risk.

Methods: An ES was used in 403 patients (57.8%), in 294 (42.2%) a DJ. ES was removed 7-12 days and DJ 3-4 weeks post-operative. Induction immunosuppression was the same in both groups. Primary outcomes at 6 months follow-up were UC (urinary leakage/ureter stenosis) and UTI; they were related to stenting procedure and clinical and transplant characteristics. The incidence of UCs was similar for ES (8.4%) and DJ (6.8%), p=0.389. ES use was a significant risk factor for UTI (OR 1.69 (1.15-2.50), p=0.008). Post-transplant hospitalization was significantly shorter in the DJ group. Despite more acute rejection episodes with ES (ES/DJ: 16.4%/6.1%, p<0.001), no clinical relevant differences in graft outcomes existed.

Discussion: A DJ is, compared to ES, associated with a lower incidence of UTIs and comparable occurrence of UCs and is therefore the preferred technique for stenting the vesicoureteric anastomosis.

Citing Articles

Long-term Double-J stenting is superior to short-term Single-J stenting in kidney transplantation.

Oudmaijer C, Muller K, van Straalen E, Minnee R, Kimenai D, Reinders M PLoS One. 2025; 20(1):e0317991.

PMID: 39883793 PMC: 11781732. DOI: 10.1371/journal.pone.0317991.

Effect of increasing age and ureteral stent implantation on urinary tract infections after kidney transplantation - update of recent literature.

Omic H, Eder M Curr Opin Urol. 2024; 34(3):146-153.

PMID: 38426237 PMC: 10990026. DOI: 10.1097/MOU.0000000000001163.

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