PURPOSE: Urinary leakage and ureteral stenosis are the most common surgical complications after kidney transplantation and are associated with significant morbidity, mortality and prolonged hospital stays. The rule of preventive double-J stent insertion at ureteroneocystostomy is still controversial. We reviewed our data to determine the incidence and possible risk factors associated with urological complications following kidney transplantation and compared the incidence in patients with and without ureteral stents.

METHODS: From May 2004 to May 2014, 1915 kidney transplants (740 living and 1175 cadaveric donors) were performed at our institution. A double-J stent (group 1) was used in 342 (17.9%) of them, and no catheter (group 2) was used in 1573 cases (82.1%). We retrospectively compared the incidence of urological complications in both groups and reviewed our data to determine the risk factors of this major complication.

RESULTS: In group 1 (double-J stent), we found 6 patients with urinary leakage (1.75%). In group 2 (without double-J stent), there were 42 urological complications (2.67%), corresponding to 37 urinary leakages and 5 ureteral stenoses (p = 0.444). We analyzed the possible risk factors for urological complications, such as receptor age and sex, donor age, type of donor (live or cadaver), multiple arteries and cold ischemia time. The type of donor was the only variable that showed a statistically significant difference in the analysis of urological complications. In the live-donor group, 3.51% had urological complications versus 1.87% in the cadaver-donor group (p = 0.035).

We found no difference in the incidence of urinary tract infections between the groups with and without double-J stents.

CONCLUSION: A retrospective review of renal transplantation performed at our center during the last 10 years showed an incidence of 2.5% for urinary complications. We did not observe a reduction of these complications with the use of double-J stents. Live-donor status was the only variable related to high incidence of urological complications.

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