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Orozco Murillo HM, Montaño Roca B, Kobashi Sandoval E, Varela Prieto J, Arzate Soriano RE, Rodriguez Domínguez J, Terrazas Cervantes MA, Campos Negrete A, Canto Castillo JM, Gebhardt D, Pliego Zermeño JA, Martinez Estaban A, Mendez-Probst CE. Are All Stent Bearers Equal? Ureteral Stent Symptoms in Kidney Transplant Patients: A Case-Control Prospective Study. J Endourol 2021; 36:410-416. [PMID: 34806408 DOI: 10.1089/end.2021.0570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: The aim of this study is to conduct a prospective, controlled single-center study to determine the prevalence and types of ureteral stent symptoms in kidney transplant (KTx) recipients and compare them with nontransplant subjects. Materials and Methods: From December 2012 to June 2019, a total of 102 patients having undergone a KTx and Double-J stent (DJS) placement and 88 patients having undergone endourological lithotripsy and DJS placement were enrolled. The Ureteral Stent Symptom Questionnaire (USSQ) was administered to patients with a median of 25 (KTx) and 31 (urolithiasis) days after stent placement. USSQ scores were used to compare symptoms between the two groups. Results: Of the 190 patients enrolled, 88 belonged to the lithotripsy group (control group) and 102 to the KTx recipients' group. Mean score for urinary symptoms was 21.42 for KTx patients vs 27.53 for control patients with statistical significance (p < 0.001, CI -7.792 to -4.433). The visual analog scale, overall bother, pain at voiding, flank pain at voiding, and frequency of painkiller use scores were significantly higher for control patients than for KTx patients (p = 0.024, <0.001, <0.001, <0.001, and 0.014, respectively). Frequency of rest, changes in work duration, work domain score, suspicion of urinary tract infection (UTI), and need for professional assistance scores were significantly lower for KTx patients than the control. There were no significant differences in general health and sexual domains between groups. Conclusions: KTx recipients have significantly fewer urinary symptoms, pain, work-related disturbances, suspected UTIs, and hospitalizations associated with stent placement than urolithiasis patients.
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Affiliation(s)
- Héctor M Orozco Murillo
- Department of Urology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de México, México
| | - Benjamín Montaño Roca
- Department of Urology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de México, México
| | - Elisa Kobashi Sandoval
- Department of Urology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de México, México
| | - Jesús Varela Prieto
- Department of Urology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de México, México
| | | | - Jorge Rodriguez Domínguez
- Department of Urology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de México, México
| | - Miguel A Terrazas Cervantes
- Department of Urology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de México, México
| | - Aaron Campos Negrete
- Department of Urology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de México, México
| | - Jose M Canto Castillo
- Department of Urology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de México, México
| | - Denisse Gebhardt
- Department of Urology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de México, México
| | - Javier A Pliego Zermeño
- Department of Urology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de México, México
| | - Alejandro Martinez Estaban
- Department of Urology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de México, México
| | - Carlos E Mendez-Probst
- Department of Urology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de México, México
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Imvrios G, Tzitzili E, Pyrpasopoulou A, Miserlis G, Daoudaki M, Fouza A, Mavroudi A, Mouloudi E, Antoniadis N, Salveridis N, Fouzas I. Association of Double-J Stenting in Renal Transplant Patients With Urinary Tract Colonization and Infections in a Multidrug-resistant Microbe Endemic Nosocomial Environment. Transplant Proc 2019; 51:408-412. [PMID: 30879553 DOI: 10.1016/j.transproceed.2019.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE We investigated the association of ureteral stenting after kidney transplantation with the development of urinary tract infections (UTIs) and/or urinary tract colonization, in a hospital environment considered endemic for multidrug resistant (MDR) Gram-negative Enterobacteriaceae. METHODS Seventy-five recipients of deceased donor grafts were divided in groups A and B. Group A (with subgroups A1 and A2) included 45 transplanted patients without urinary stenting, and group B 30 patients with stenting. Subgroup A1 consisted of 30 patients transplanted before 2006, and A2 of 15 patients transplanted after 2006, when MDR, mainly carbapenem-resistant, Enterobacteriaceae, frequency has risen in our hospital. RESULTS The incidence and the number of UTIs per patient were significantly higher in patients without stenting compared to those with stenting. (Group A: 32/45 vs group B: 9/30, P < .001, and group A: 2.86 ± 0.43 vs group B: 0.6 ± 0.19, P < .01 respectively). Patients without stenting tended to have a higher frequency of recurrent UTIs compared to those with stenting (group A: 16/45 vs group B: 4/30, P < .05). Asymptomatic bacteriuria was more frequent in the patients with stent (group A: 8/45 vs group B: 14/30, P < .05). Further sub-comparison of the A1 and A2 subgroups with group B did not change the statistical results. CONCLUSIONS There is no clinically significant association of ureteral stenting after kidney transplantation with the high frequency of MDR Gram-negative bacteria in our hospital.
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Affiliation(s)
- G Imvrios
- Division of Transplantation, Department of Surgery, Hippokration General Hospital, Thessaloniki, Greece
| | - E Tzitzili
- Division of Transplantation, Department of Surgery, Hippokration General Hospital, Thessaloniki, Greece
| | - A Pyrpasopoulou
- Infectious Diseases Unit, Hippokration General Hospital, Thessaloniki, Greece
| | - G Miserlis
- Division of Transplantation, Department of Surgery, Hippokration General Hospital, Thessaloniki, Greece.
| | - M Daoudaki
- Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - A Fouza
- Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - A Mavroudi
- 3rd Paediatric Department, Hippokration General Hospital, Thessaloniki, Greece
| | - E Mouloudi
- Intensive Care Unit, Hippokration General Hospital, Thessaloniki, Greece
| | - N Antoniadis
- Division of Transplantation, Department of Surgery, Hippokration General Hospital, Thessaloniki, Greece
| | - N Salveridis
- Division of Transplantation, Department of Surgery, Hippokration General Hospital, Thessaloniki, Greece
| | - I Fouzas
- Division of Transplantation, Department of Surgery, Hippokration General Hospital, Thessaloniki, Greece
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Abdulmajed MI, Jones VW, Shergill IS. The first use of Resonance(®) metallic ureteric stent in a case of obstructed transplant kidney. Int J Surg Case Rep 2014; 5:375-7. [PMID: 24858983 DOI: 10.1016/j.ijscr.2014.01.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 11/24/2013] [Accepted: 01/27/2014] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION To date, double JJ stent is the mainstay ureteric stent used in a transplant kidney. We herein report the first use of Resonance(®) metallic ureteric stent to manage ureteric obstruction in a transplant kidney. PRESENTATION OF CASE A 45-year-old lady underwent an uneventful living related donor renal transplantation. Due to post-operative pelvi-ureteric obstruction and recurrent obstruction following multiple distal stent migration and expulsion necessitated frequent nephrostomy insertion and antegrade stenting, she underwent challenging but successful retrograde insertion of a 12 centimetres long and size 6.0 French Cook Resonance(®) metallic ureteric stent which was performed under general anaesthesia. DISCUSSION Metallic ureteric stents are a fairly recent introduction to modern urology and they have been successfully used in the management of benign and malignant obstruction of ureter. CONCLUSION This is the first case of therapeutic metallic ureteric stent insertion in a transplant kidney.
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