Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSION: Early bedside ureteral stent removal was feasible, with a high satisfaction rate and a lower risk of UTI without a significant increase of MUC.