The Effect of the Use of Ureteric Stents on Urological Complications in Selected Kidney Transplant Cases

OBJECTIVES: The routine use of a ureteric stent remains controversial due to high incidence of its complications. In our routine practice, we prefer selective stenting of problematic anastomoses. The aim of this study is to evaluate incidence of major urological complications in recipients with selective ureteral stenting and without ureteral stenting.

MATERIAL and METHODS: We retrospectively reviewed 236 patients who received a kidney transplant (144 living related, 88 cadaver) in our clinic between 2001 and 2009. All patients underwent extravesical Lich-Gregoir ureteroneocystostomy. Ureteral stenting had been used only in patients who had a high risk of urological complications.

RESULTS: A total of 236 kidney transplantation had been performed between 2001 and 2009. Of these 236 patients, a total of 6 were excluded due to primary non-function. Of the remaining 230 procedures, 164 (71%) performed without ureteral stent. Overall 17 (7.4%) urological complications were observed. Urological complication rates were 6.1% and 10.6 % in the non-stented and selectively stented group, respectively. In the living related donor group, a total of 6 patients (4.2%) had urological complications. Urological complications further decreased to 3.3% in patients who received a living donor kidney without stenting.

CONCLUSIONS: Kidney transplantation without ureteric stenting is safe in patients at low risk for urological complications. We prefer stentless ureteroneocystostomy surgery in low risk living related kidney transplantation. Selective ureteral stenting may be recommended high risk group for urological complications.