Timing of Ureteric Stent Removal and Occurrence of Urological Complications after Kidney Transplantation: A Systematic Review and Meta-Analysis
Open Access
- 16 May 2019
- journal article
- review article
- Published by MDPI AG in Journal of Clinical Medicine
- Vol. 8 (5), 689
- https://doi.org/10.3390/jcm8050689
Abstract
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) (OR 0.60, CI 95%, 0.29 to 1.23, p = 0.16). Based on our results, earlier stent removal (3 weeks). We recommend that the routine removal of ureteric stents implanted during KTx should be performed around three weeks post-operatively.This publication has 40 references indexed in Scilit:
- Impact of Early Ureteric Stent Removal and Cost-Benefit Analysis in Kidney Transplant Recipients: Results of a Randomized Controlled StudyTransplantation Proceedings, 2012
- Is early removal of prophylactic ureteric stents beneficial in live donor renal transplantation?Indian Journal of Nephrology, 2012
- Effects of Ureteral Stent on Urologic Complications in Renal Transplant Recipients: A Retrospective StudyRenal Failure, 2009
- Kidney Transplantation as Primary Therapy for End-Stage Renal DiseaseClinical Journal of the American Society of Nephrology, 2008
- Impact of Stents on Urological Complications and Health Care Expenditure in Renal Transplant Recipients: Results of a Prospective, Randomized Clinical TrialJournal of Urology, 2007
- EVALUATION OF THE UROLOGICAL COMPLICATIONS OF LIVING RELATED RENAL TRANSPLANTATION AT A SINGLE CENTER DURING THE LAST 10 YEARS: IMPACT OF THE DOUBLE-J STENTJournal of Urology, 2000
- EVALUATION OF THE UROLOGICAL COMPLICATIONS OF LIVING RELATED RENAL TRANSPLANTATION AT A SINGLE CENTER DURING THE LAST 10 YEARS: IMPACT OF THE DOUBLE-J* STENTJournal of Urology, 2000
- Comparison of Mortality in All Patients on Dialysis, Patients on Dialysis Awaiting Transplantation, and Recipients of a First Cadaveric TransplantThe New England Journal of Medicine, 1999
- Ureteric Obstruction in Stented Renal TransplantsBJU International, 1988