Timing of Double-J Stent Removal and Occurrence of Urological Complications

Visser, Isis J.; Staaij, Jasper Pt Van Der; Lafranca, Jeff A; Dor, Frank J. M. F.

doi:10.1097/01.tp.0000542679.37320.60

Cited by 2 publications

(3 citation statements)

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“…All aspects of the Cochrane Handbook for Interventional Systematic Reviews were followed, and the study was written according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement [25,26]. Details of the protocol for this systematic review were registered on PROSPERO (ID: CRD42018079867) and can be accessed online [27].…”

Section: Methodsmentioning

confidence: 99%

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: Methodsmentioning

confidence: 99%

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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“…There is no consensus on the optimal time to remove the transplant ureteric stent. A recent meta‐analysis on the current practice of ureteric stent removal found that removal within 3 weeks after transplantation is associated with a significant reduction in UTIs without risking an increased incidence of MUCs 17 . Our multi‐centre randomized controlled trial on the optimal duration for stents in pediatric and adult renal transplantation (TrUST trial—ISRCTN09184595) found that removing stents early (at 5 days) rather than later (at 6 weeks) significantly reduced the rate of stent‐related complications 26 …”

Section: Discussionmentioning

confidence: 85%

“…Studies have supported the use of routine intraoperative transplant ureteric stenting to reduce the incidence of MUCs, despite the increased risk of urinary tract infection 17‐25 . MUCs usually lead to renal allograft dysfunction and can be detected on an USS.…”

Section: Introductionmentioning

confidence: 99%

No evidence for the need of a routine renal transplant ultrasound after elective transplant ureteric stent removal—A retrospective cohort study

Hussein

Sran

Ali

et al. 2020

Pediatric Transplantation

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Transplant ureteric stent insertion reduces the incidence of MUCs, but it is not known whether routine PSRGU is needed to detect unmasked MUCs. This study evaluated whether routine PSRGU in the pRTR is a useful tool to identify MUCs before they become clinically apparent. A retrospective analysis was undertaken of the clinical outcomes following elective stent removal from pediatric kidney‐only transplant recipients at two London centers between 2012 and 2016. Our policy was to perform PSRGU either routinely or urgently if there were concerning symptoms or biochemical evidence of renal allograft dysfunction. Elective stent removal was performed in 86% (97 of 113 pRTR), and 75 (77%) of whom had routine PSRGU at a median (IQR) of 6 (2‐8) days after stent removal. There were changes to management in 3 (4%) of pRTR with PSRGU identifying no MUC. Nineteen patients (25%) had urgent PSRGU, most commonly due to renal allograft dysfunction, at a median (IQR) of 5.5 (2.7‐12.3) days after stent removal. Of these, two pRTR required ureteric intervention. For our current practice of removing transplant stents at 4‐6 weeks post‐transplantation, our study has found no evidence to support routine PSRGU after elective stent removal.

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Timing of Double-J Stent Removal and Occurrence of Urological Complications

Cited by 2 publications

References 0 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

No evidence for the need of a routine renal transplant ultrasound after elective transplant ureteric stent removal—A retrospective cohort study

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