Role of Selective Double-J Stenting in Renal Transplantation

Abstract

Prophylactic insertion of Double-J(DJ) stent remains controversial in renal transplantation. Recent studies regarding DJ stenting concluded that their routine use improved outcomes. But they also lead to adverse complications, leading to advocation of stenting in selected situations. The objective is to analyze the potential benefit and drawbacks of selective DJ stenting across a ureteroneocystostomy in renal transplant recipients at a single centre. A total of 81 patients were operated and followed up in our study. 39 patients (Group 1) had a Double-J stent placed because of various factors while it was not placed in 42 patients (Group 2). Urological complications like leaks, obstruction, urinary tract infection were compared between these 2 groups. In group 1, 14 out of 39 (35.89%) and in group 2, 6 out of 42 (14.28%) developed urinary tract infection, which is statistically significant (P=0.024). There was no occurrence of urinary leaks or collecting system obstruction in either group. The mean serum creatinine at discharge was 1.14±0.26 mg% and 1.05±0.22 mg% in groups 1 and 2, respectively (P=0.94). There was one case of forgotten Double-J stent, which was later removed. Our results demonstrate that many patients can be successfully transplanted without the use of Double-J stent. Double-J stent insertion increases the incidence of urinary tract infection. So routine Double-J stenting should be avoided as much as possible unless otherwise indicated.