Prophylactic Double J Stent and Major Urological Complications during Extravesical Ureteroneocystostomy in Kidney Transplant Recipients.

Abstract

Introduction: Renal transplantation is the renal replacement therapy of choice in patients with end-stage chronic kidney disease. Major urological complications such as urinary leakage, ureteral stricture and urinary tract infection, usually occur in the first three months post-transplantation and lead to a higher morbidity and mortality and lower graft function.

Objective: To evaluate the impact of double J catheter colocation on major urological complications in extravesical ureteroneocystostomy in renal recipients.

Methods: Open clinical trial. The study included renal transplant recipients who underwent extravesical ureteroneocystostomy with trans-surgical placement of double J catheter compared to extravesical ureteroneocystostomy without trans-surgical catheter placement. The study variables were urinary leakage, ureteral stricture, urinary tract infection, surgical complications and graft function.

Results: 84 patients were included, 42 patients in the study group and 42 in the control group, who had a mean follow-up of 10.7 months. Of the urological complications presented: 4 (4.8%) patients with urinary leakage, all in the non-catheter group (RR 0.475 95% CI 0.377-0.598, p = 0.04); 2 (2.4%) patients with ureteral stricture, one in each group (RR 1 95% CI 0. 246-4.066, p = 1.0); and 20 (23.8%) patients with urinary tract infection, being 9 (21.4%) patients in the control group and 11 (26.2%) in the study group (RR 1.135 CI 95% 0.710-1.817, p = 0.608). No differences regarding graft function were observed.

Conclusion: Our study showed a significant reduction in the incidence of urinary leakage with prophylactic ureteral catheter use, although no significant association was observed with other complications such as ureteral stricture or surgical complications. Furthermore, its use was not significantly associated with urinary tract infections or graft dysfunction.