[Should double J catheter be systematically considered in renal transplantation?]

Area of Science:

• Urology
• Nephrology
• Transplantation Surgery

Context:

• Ureteral catheter (double J sound) insertion is common in urology but its systematic use in renal transplantation is debated.
• Practices vary between systematic insertion to prevent ureteral complications and selective use based on risk assessment.

Purpose:

• To analyze the risks, costs, and infectious complications associated with the systematic use of double J stents in Lich-Gregoir ureterovesical anastomoses during renal transplantation.
• To evaluate the benefits of systematic double J stent placement in preventing ureteral complications.

Summary:

• Systematic double J stent insertion in renal transplantation is questioned due to potential complications (infection, incrustation, hemorrhage), increased costs, and limited necessity in over 90% of cases.
• Conversely, some advocate for systematic use, believing it reduces ureteral fistulas and stenosis.
• This article critically examines the trade-offs of systematic versus selective stenting.

Impact:

• Provides evidence to inform clinical decision-making regarding the routine use of double J stents in renal transplantation.
• Highlights the importance of considering technical surgical factors over routine stenting for preventing ureteral complications.
• Contributes to optimizing patient outcomes and resource allocation in kidney transplantation.