The effect of ureteral stenting on urological complications in early period, infection and long term graft survival in cadaveric renal transplantations

Objective: Intraoperative ureteral stenting is used to reduce urological complicatons in cadeveric renal transplantation. However, according to some studies it also increases the risk of urinary tract infections. This study aims to investigate the relationship of ureterel stenting with early urinary complications, infection and long term graft survival in cadeveric renal transplant recipients. Patients and Methods: 150 patients that received cadaveric renal transplants in İstanbul University, İstanbul Faculty of Medicine Transplantation Unit were included in the study. Prophylactic ureteral stents were not used in 78 patients and were used in 72 patients. These two groups were compared with regard to urological complications in early period, urinary tract infections and urine culture results in the first month after transplantation, antibiotic use, CMV infection, BK viruria and BK viremia, length of hospitalization, presence of rejection and graft loss. Results: Postoperative early urological complications were significantly reduced in the group of patients with ureteral stenting (p=0.004). Interestingly, frequency of urinary tract infections were also significantly lower in the group with ureteral stents (p<0.001). There was no statistical significance in frequency of CMV infection, BK viruria, BK viremia, graft survival and rejection between the groups. Duration of ATG usage and duration of Foley catheter usage was significantly shorter in the group of patients with urinary stenting. Conclusions: Routine ureteral stenting in cadaveric renal transplant recipients, is protective for urological complications without increasing the incidence of early urinary tract infections. The significant reduction of early urinary tract infections in the group of patients with ureteral stenting could be associated with significantly shorter durations of ATG usage and Foley catheter usage. In the long term follow-up, ureteral stenting use did not have any effect on graft survival.