You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation, Vascular Surgery I1 Apr 20122130 RETROSPECTIVE REVIEW OF URETERIC COMPLICATIONS POST RENAL TRANSPLANT WITH PROPHYLACTIC VS. SELECTIVE URETERAL STENTING Michael Ordon, Daniela Ghiculete, Robert Stewart, Kenneth T. Pace, and R. John D'A. Honey Michael OrdonMichael Ordon Toronto, Canada More articles by this author , Daniela GhiculeteDaniela Ghiculete Toronto, Canada More articles by this author , Robert StewartRobert Stewart Toronto, Canada More articles by this author , Kenneth T. PaceKenneth T. Pace Toronto, Canada More articles by this author , and R. John D'A. HoneyR. John D'A. Honey Toronto, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2300AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Vesicoureteric complications after renal transplantation can result in urinary leak or ureteral obstruction, which has led to the notion of prophylactic stenting in all patients to prevent these complications. The use of prophylactic stents has been studied, but unfortunately, the issue remains controversial. At our centre prior to Sept. 9, 2008, stents were placed only when deemed necessary by the surgeon (selective). Since then, ureteric stents have been placed in all patients (prophylactic) undergoing transplantation. Our objective was to review all transplants performed at our centre over the past 5 years to evaluate the role of prophylactic versus selective stenting in the development of post-operative ureteric complications. METHODS A retrospective review of 588 patients who underwent renal transplantation from Jan. 2006- May 2011 was completed. Our primary outcome was the rate of ureteral complication, defined as the development of ureteric obstruction or uretero-vesical anastomotic leak. Our secondary outcomes were the rate of urinary tract infections (UTI) and forgotten stents (FS). Using the Chi square test, we compared our primary and secondary outcomes across the selective and prophylactic cohorts. Logistic regression analysis was used to compare the two cohorts while adjusting for potential confounders. RESULTS The selective cohort consisted of 258 patients and the prophylactic cohort 330 patients. The two groups were comparable for age and performing surgeon, but differed significantly for gender and donor type (live/deceased). In the selective group, 38% of patients had a stent compared to 99% in the prophylactic group. For our primary outcome, unadjusted analysis demonstrated that the prophylactic group had a significantly lower rate of ureteral complication compared to the selective group (2.7% vs. 9.3%, OR 0.27, p=0.0006). After adjusting for differences in gender and donor type across the two groups with logistic regression, the prophylactic group was still associated with a significantly lower risk of ureteral complication (OR 0.25, p=0.0006). For our secondary outcomes, there was no significant difference in the rate of UTI's (20.9% vs. 16.7%) and FS (4.2% vs. 3.9%) across the prophylactic and selective groups. CONCLUSIONS Our retrospective review of renal transplant patients found that prophylactic stenting significantly reduced the rate of post-operative ureteral complications compared to selective stenting. Furthermore, the increased use of stents in the prophylactic group did not result in more UTI's or FS. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e860 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Ordon Toronto, Canada More articles by this author Daniela Ghiculete Toronto, Canada More articles by this author Robert Stewart Toronto, Canada More articles by this author Kenneth T. Pace Toronto, Canada More articles by this author R. John D'A. Honey Toronto, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...