title: Double-J Versus External Ureteral Stents in Kidney Transplantation: A Retrospective Analysis.
abstract: BACKGROUND
  Kidney transplantation has long been recognized as the best available therapy for end stage kidney disease.
  
  
  OBJECTIVE
  This study aimed to compare outcomes of double-J versus percutaneous ureteral stent placement in renal transplantation.
  
  
  METHODS
  A retrospective analysis was performed on data of renal transplantations performed at our institution in a 12-month period. In this period, external and double-J stents were used in parallel. Length of hospital stay and stent-associated complications were evaluated.
  
  
  RESULTS
  In 76 kidney transplants, 43 external (group 1) and 33 double-J (group 2) urinary stents were used. No significant difference was observed in the number of urinary tract infections, ureteric stenosis or necrosis. The mean overall length of hospital stay was comparable in both groups (20.7 days in group 1 vs 19.3 days in group 2, P = 0.533). For patients without immunological complications, the hospital stay was significantly reduced using double-J stents (12.9 days in group 1, 10.8 days in group 2, P = 0.018). Leakage of the ureteroneocystostomy occurred in 6 out of 43 patients in group 1 (13.9%). No case of anastomotic insufficiency was observed in group 2 (P = 0.035). Macrohematuria was detected in 13 out of the 43 patients in group 1 (30.2%), compared to 3 out of 33 patients in group 2 (9.1%; P = 0.045).
  
  
  CONCLUSIONS
  This nonrandomized comparison of stent types in kidney transplantation supports the use of prophylactic double-J stents in terms of decreased ureteric complications and reduced length of hospital stay.
authors.affiliation: Department of General and Visceral Surgery, University Hospital Munster, Munster, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Vogel
authors.affiliation: Department of General and Visceral Surgery, Knappschafts Hospital, Recklinghausen, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Utech
authors.affiliation: Department of General and Visceral Surgery, University Hospital Munster, Munster, Germany.
authors.forename: Fabian
authors.initials: F
authors.lastname: Schmidt
authors.affiliation: Department of General and Visceral Surgery, University Hospital Munster, Munster, Germany.
authors.forename: Wiebke
authors.initials: W
authors.lastname: Holscher Keplin
authors.affiliation: Department of General Surgery, Bruderkrankenhaus St. Josef, Paderborn, Germany.
authors.forename: Ricarda
authors.initials: R
authors.lastname: Diller
authors.affiliation: Organ Transplant Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors.forename: Jens
authors.initials: J
authors.lastname: Brockmann
authors.affiliation: Department of General and Visceral Surgery, University Hospital Munster, Munster, Germany.
authors.forename: Heiner
authors.initials: H
authors.lastname: Wolters
keywords: Kidney Transplantation; Stent; Ureter