Double J stent with antireflux device in the prevention of short-term urological complications after cadaveric kidney transplantation: single-center prospective randomized study.
The placement of a double J stent to protect a uretero-vesical anastomosis in a kidney transplant is a widespread procedure performed to reduce the incidence of fistula and stenosis at the anastomosis. However, the presence of a double J stent may cause vesicoureteral reflux (VUR), predisposing one to urinary tract infections (UTIs), which may be a significant source of morbidity for the graft. We evaluated whether a ureteral stent incorporating an antireflux device can reduce the incidence of ureteral reflux and UTIs. From January to December 2003, 44 kidney transplant recipients were randomized to receive a 14-cm 4.8-F double J stent with (group A) or without an anti-reflux device (group B). Primary end points were the reduction of the incidence of VUR and of UTIs. The secondary end point was the graft function, on the basis of mean serum creatinine level at 3, 6, and 12 months. We failed to observe statistically significant differences in terms of either the incidence of VUR and UTIs, or the short-term outcomes of the grafts. We concluded that the anti-reflux device does not have an impact on the incidence of stent-related side effects.
Battaglia
M
M
Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy. battaglia@urologia.uniba.it
Ditonno
P
P
Selvaggio
O
O
Palazzo
S
S
Bettocchi
C
C
Peschechera
R
R
Di Paolo
S
S
Stallone
G
G
Schena
A
A
Grandaliano
G
G
D'Orazio
E
E
Selvaggi
F P
FP
D000328:Adult; D002102:Cadaver; D004867:Equipment Design; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D009017:Morbidity; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control / Q000601:surgery; D011446:Prospective Studies; D015607:Stents / Q000009:adverse effects; D014019:Tissue Donors; D014570:Urologic Diseases / Q000453:epidemiology / Q000517:prevention & control*; D014718:Vesico-Ureteral Reflux / Q000517:prevention & control*