Advantages of Short-Time Ureteric Stenting for Prevention of Urological Complications in Kidney Transplantation: An 18-Year Experience

Sansalone, C. V.; Maione, G; Aseni, Paolo; Mangoni, I.; Soldano, S.; Minetti, Enrico; Radaelli, L.; Civati, G

doi:10.1016/j.transproceed.2005.06.035

Cited by 56 publications

(50 citation statements)

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“…Their frequency varies among centers with different practices from 2.9% to 21%. [1][2][3][4][5][6] The most common urologic complication after renal transplant involves the ureter. Urine leak and distal ureter stenosis make up 90% of complications.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of ureteral complications after renal transplant varies from 2.9% to 21% with an associated 20% to 30% mortality rate according to previous reports. [1][2][3][4][5][6] The most common urologic complications after renal transplant are those involving the ureter. 1,2 Leaks or obstructions make up more than 90% of urologic problems after transplant; leaks occur because of ischemic or mechanical injury to the ureter and also technical difficulties with the anastomosis makeup.…”

Section: Introductionmentioning

confidence: 99%

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Untitled

2017

Exp Clin Transplant

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Objectives: Urologic complications after kidney transplant are associated with significant morbidity, mortality, and prolonged hospital stay. An intervention or second surgical procedure is frequently required. Here, we report urologic complications in adult kidney recipients. Materials and Methods: Since 2006, 171 adult kidney transplant procedures have been performed at the Gazi University Transplantation Center (Ankara, Turkey). Among these patients, there were 65 adult female (38%) and 106 adult male (62%) recipients. Donor source included 61 deceased donations (36%) and 110 living related donations (64%). The Haberal corner-saving technique was used for ureteroneocystostomy anastomosis. All recipients received a calcineurin-based triple immunosuppression regimen. All recipients also received trimethoprim/sulfamethoxazole prophylaxis for 3 months after transplant. Results: In the 171 adult kidney recipients analyzed for urologic complications, mean age was 32.5 ± 14.1 years (median: 32.5 y; range, 18-67 y); mean donor age was 41 ± 14.2 years (median: 42 y). We focused on 3 specific urologic complications: urine leak, ureteric stenosis, and symptomatic vesicoureteral reflux. In our study group, urologic complications were encountered in 7 patients (4%), with 5 complications detected in the early period and 2 complications detected in the late period. No symptomatic vesicoureteral reflux complications were shown in this study group. Urologic complications did not result in any patient deaths or graft loss. Conclusions: In this study, the Haberal corner-saving suture technique with double J stent seemed to have a protective effect for development of urologic complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Untitled

2017

Exp Clin Transplant

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“…In their study on 590 consecutive patients, the rates of urinary leakage and ureteral stenosis were 0.3% and 1.5%, which are results similar to those shown in our present study. 15 Dong and associates introduced another technique in which a 2-0 silk suture was passed through the venting side hole of the double J stent into the bladder. After the Foley catheter is removed, the stream of urine would push the free end of the silk suture out from urethra and the double J is thus removed by simply withdrawing the silk suture from the urethra.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2016

Exp Clin Transplant

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Objectives: Inserting a double J stent during kidney transplant has reduced the rate of urologic complications. Traditionally, a double J stent is removed via endoscopic intervention. Here, we assessed the safety and efficacy of a nonoperative method for double J stent removal. Materials and Methods: Our study group included 200 consecutive patients who underwent kidney transplant from January 2013 to April 2014. Group A consisted of 100 recipients who had a double J stent that was tied to a Foley catheter with 2-0 silk suture. The stent was simply removed by taking out the Foley catheter after 3 weeks. Patients in group A were compared with a second group of 100 kidney transplant patients whose stents were removed endoscopically 3 weeks later (group B). Results: Patients were matched between the 2 groups regarding age distribution, male-to-female patient ratio, deceased versus living donor graft, prevalence of type 2 diabetes mellitus, and body mass index. The incidence of urinary fistula (3% in group A and 4% in group B; P = .7), ureteral stenosis (1% in group A and 2% in group B; P = .56), wound infection (1% in group A and 2% in group B; P = .56), and positive urine culture (20% in group A and 29% in group B; P = .14) after stent removal were not significantly different between the 2 groups. Conclusions: This study shows that nonoperative removal of a double J stent is a safe and effective method. This approach is simple, and there is no need for a surgical procedure or any outpatient surgical intervention.

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“…Accordingly, they may prolong duration of hospitalization, and require additional surgical intervention. [2] Urinary retention due to bladder outlet obstruction (BOO) is an important urological problem which may be especially encountered in men older than 50 years within the short-, or long-term after RT. BOO may develop due to bladder neck obstruction (BNO) or benign prostatic hyperplasia (BPH).…”

Section: Introductionmentioning

confidence: 99%

The outcomes of transurethral incision/resection of the prostate (TUIP/TURP) performed early after renal transplantation

Sarıer

Duman

Demir

et al. 2018

Turkish Journal of Urology

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Objective: In the early period after renal transplantation, urinary retention stemming from bladder outlet obstruction (BOO) may directly affect graft success. The aim of this study was to evaluate the early and long-term outcomes of transurethral resection of the prostate (TURP) and transurethral incision of prostate (TUIP) procedures performed in the first month following RT due to BOO. Material and methods:Between February 2009 and March 2016, 38 male patients underwent TURP/ TUIP due to BOO within the first 30 days of renal transplantation. The urodynamic and renal function assessment results of all patients were collected during the pre-and postoperative periods. All patients were followed up for a minimum of 12 months for short and long-term complications. The results were evaluated retrospectively. Results:The mean age of the patients who underwent operations was 59.2±12 years. The median duration of dialysis was 41 months (range 0-180). Before the operation the mean serum creatinine (sCr) level was 1.8±0.7 mg/dL, the mean total PSA level was 1.6±1.1 ng/mL. Of the voiding parameters, the mean Qmax and Qave were measured as 8.2±4.5 mL/sec and 4.6±2.5 mL/sec, respectively. The median post-micturition residual urine (PMR) was 105 mL (range 10-400). TURP/TUIP operations were performed at a median of 19 days (range 8-30) after renal transplantations. None of the patients experienced major complications. In the early postoperative period, 5 patients (13.1%) developed urinary tract infection. The mean decrease in sCr in the first month following TURP/TUIP was 1.4±0.4 mg/dL (p<0.001). The mean Qmax (22.4±11.1 mL/sec), and Qave (11.7±5.4 mL/sec) increased significantly (p<0.001), while the median PMR (15 mL, range 0-205) decreased significantly (p<0.001). The mean follow-up period after the procedure was 46.8±23.3 months. During the follow-up period, 3 (7.8%) patients suffered from urethral stricture and 2 (5.2%) patients from bladder neck obstruction. Conclusion:In the surgical treatment of urinary retention arising from BOO in the first month following renal transplantation, TURP/TUIP yield safe and successful results. In addition, regarding the short and long term outcomes, these procedures may be safely performed with low morbidity.

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Advantages of Short-Time Ureteric Stenting for Prevention of Urological Complications in Kidney Transplantation: An 18-Year Experience

Cited by 56 publications

References 32 publications

Untitled

Untitled

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The outcomes of transurethral incision/resection of the prostate (TUIP/TURP) performed early after renal transplantation

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