Simplified Double J Stent Removal: Retrograde Fluoroscopy-Guided Technique and Outcomes in Kidney Transplant Patients

Fluoroscopy-guided retrograde removal of double J stents is gaining popularity as an alternative method in renal transplant patients. Compared with traditional cystoscopic removal, this approach offers increased patient comfort and eliminates the need for urine culture and general anesthesia. We aimed to evaluate the safety and efficacy of this procedure in renal transplant patients.

A retrospective analysis was applied to 244 kidney transplant recipients. A fluoroscopy-guided double J stent removal procedure was performed using a simple snare technique through a transurethral vascular sheath. Rarely did this method fail; alternative methods, such as pigtail and alternative loop techniques, were used when needed. The characteristics of patients and procedures were recorded and analyzed.

We enrolled 244 patients in this study (68.9% male; 31.1% female), and we performed 281 pro-cedures on 244 patients (mean age 37.68 years; range, 2-69 years). Technical success was achieved at 97.9% in procedures. There were no major complications. Ten patients had mild hematuria following the procedure, which resolved spontaneously 1 day later. Three patients had a urine infection following the procedure, which resolved after appropriate medical therapy. The mean fluoroscopy time was 11.1 minutes (range, 0.8-50.6 min). The mean radiation dose of the procedure was 13.0 Gy·cm² (range, 1.02-51.23 Gy·cm²).

Fluoroscopy-guided transurethral removal of double J stents in renal transplant patients is a safe and efficient method. Conducted in the angiography suite, this procedure eliminates the need for urine culture and general anesthesia and thereby improves patient comfort and simplifies the process.