Early Stent Removal at Bedside Decreases Urinary Tract Infection in Kidney Transplant Recipients: A Monocentric...

During kidney transplantation, the use of a ureteral stent reduces the risk of major urological complications (MUC). However, it is associated with infectious complications and usually requires a second procedure to be removed. The goal of this pilot study was to evaluate the impact of early ureteral stent removal at bedside.

We prospectively included all consecutive kidney transplant recipients at our center between May 2020 and May 2021. During the first 6 months, all consecutive patients had routine removal of the ureteral stent as an outpatient procedure (Group 1). During the last 6 months, all patients had early removal of the ureteral stent at bedside before leaving the hospital, using a grasper-integrated single-use flexible cystoscope (Group 2). The primary endpoint was feasibility and patient satisfaction. Secondary endpoints were rate of urinary tract infections (UTI) and major complications.

Overall, 151 patients were included, 84 in Group 1 and 67 in Group 2. The characteristics of the two groups were similar. There was no failure of the bedside early stent removal procedure, with a mean overall satisfaction score of 9/10 (rank: 4-10). The rate of MUC was similar in the two groups. In multivariate analysis, early removal of the ureteral stent was a significant predictor of a lower risk of UTI (OR = 0.49; IC95% [0.23; 0.98]; p = 0.047).

Early bedside ureteral stent removal was feasible, with a high satisfaction rate and a lower risk of UTI without a significant increase of MUC.