title: [The use of ureteral stents and catheters in renal transplantation.]
abstract: Mayor urological complications, fistulae and stenosis, mainly affect the vesicoureteral anastomosis and present in the early post-transplant period. The systematic use of ureteral catheters keeps selecbeing controversial with many groups using them only selectively depending on the existence of pretransplant or intraoperative risk factors.
  
  
  METHODS
  We performed a bibliographic review through automatized search in the Medline bibliographic database, as the main bibliographic source, and also in Clinical Key. The search strategy included the following terms: "stent" AND "kidney transplantation".
  
  
  RESULTS
  The bibliographic search revealed the protective effect of the use of ureteral catheters in the transplant ureteroneocystostomy for both development of fistulae (RR 0.29, 0.12 to 0.74, p=0.009) and stenosis (RR 0.27, 0.09 to 0.81, p=0.02). The use of catheters in immunosuppressed patients was associated with significant increase of the incidence of post-transplant urinary tract infections (RR 1.49 IC 95% 1.04 to 2.15, p=0.03) that was prevented by antibiotic prophylaxis with cotrimoxazole directed against pneumocistis carinii. The rates of permeability of self-expandable metallic stents and extra-anatomic bypasses in the treatment of ureteral stenosis after renal transplantation in high surgical risk patients or after the failure of previous surgery, has varied from 50% to 100%, with a limited number of patients included.
  
  
  CONCLUSIONS
  The use of ureteral catheters in the extravesical ureteroneocystostomy reduces the incidence of anastomotic complications. Surgery is the treatment of choice of post-transplant ureteral stenosis. The use of metallic stents and extra-anatomic bypasses should be limited to complex ureteral stenosis when primary therapy has failed, in high surgical risk patients or chronic graft dysfunction.
authors.affiliation: Servicio de Urología. Hospital Universitario Ramón y Cajal. Madrid. España. IRYCIS. Universidad de Alcalá. Madrid. España.
authors.forename: V
authors.initials: V
authors.lastname: Gómez-Dos Santos
authors.affiliation: Servicio de Urología. Hospital Universitario Ramón y Cajal. Madrid. España. IRYCIS. Universidad de Alcalá. Madrid. España.
authors.forename: V
authors.initials: V
authors.lastname: Díez-Nicolás
authors.affiliation: Servicio de Urología. Hospital Universitario Ramón y Cajal. Madrid. España. IRYCIS. Universidad de Alcalá. Madrid. España.
authors.forename: L
authors.initials: L
authors.lastname: Martínez-Arcos
authors.affiliation: Servicio de Urología. Hospital Universitario Ramón y Cajal. Madrid. España. IRYCIS. Universidad de Alcalá. Madrid. España.
authors.forename: J J
authors.initials: JJ
authors.lastname: Fabuel-Alcañiz
authors.affiliation: Servicio de Urología. Hospital Universitario Ramón y Cajal. Madrid. España. IRYCIS. Universidad de Alcalá. Madrid. España.
authors.forename: I
authors.initials: I
authors.lastname: Laso-García
authors.affiliation: Servicio de Urología. Hospital Universitario Ramón y Cajal. Madrid. España. IRYCIS. Universidad de Alcalá. Madrid. España.
authors.forename: S
authors.initials: S
authors.lastname: Álvarez-Rodríguez
authors.affiliation: Servicio de Urología. Hospital Universitario Ramón y Cajal. Madrid. España. IRYCIS. Universidad de Alcalá. Madrid. España.
authors.forename: F
authors.initials: F
authors.lastname: de Asís Donis-Canet
authors.affiliation: Servicio de Urología. Hospital Universitario Ramón y Cajal. Madrid. España. IRYCIS. Universidad de Alcalá. Madrid. España.
authors.forename: V
authors.initials: V
authors.lastname: Hevia-Palacios
authors.affiliation: Servicio de Urología. Hospital Universitario Ramón y Cajal. Madrid. España. IRYCIS. Universidad de Alcalá. Madrid. España.
authors.forename: M
authors.initials: M
authors.lastname: Ruiz-Hernández
authors.affiliation: Servicio de Urología. Hospital Universitario Ramón y Cajal. Madrid. España. IRYCIS. Universidad de Alcalá. Madrid. España.
authors.forename: F J
authors.initials: FJ
authors.lastname: Burgos-Revilla
mesh_terms: D006801:Humans; D016030:Kidney Transplantation; D011183:Postoperative Complications / Q000628:therapy*; D015607:Stents; D062885:Urinary Catheters