Is routine ureteral stenting cost-effective in renal transplantation?

J Urol. 2007 Dec;178(6):2509-13; discussion 2513. doi: 10.1016/j.juro.2007.08.037. Epub 2007 Oct 15.


Purpose: Recent collective reviews show that ureteral stenting provides a decrease in ureteroneocystostomy anastomotic complications following renal transplantation. We identified the specific morbidity associated with urinary complications following renal transplantation and quantified the health care resources required to treat these patients at a high volume center.

Materials and methods: Prospective databases were used to identify patients with a renal transplant who had urinary complications and track postoperative hospital readmissions and admission diagnostic codes. Financial models were used to estimate the variable direct costs of prophylactic stent placement and removal. Cost based analysis was performed to assess the financial feasibility of routine stenting following renal transplantation.

Results: Patient specific morbidity and hospital readmissions were significantly increased in patients with a transplant who had a urinary complication. The incremental hospital costs incurred in a patient with a renal transplant who had urinary leakage during the first 12 months postoperatively was $20,121. Routine placement of an anastomotic stent was inexpensive. Approximately 22 or 23 stents could be placed at the same incremental cost of treating 1 patient with a urinary complication in the hospital.

Conclusions: Urinary anastomotic complications following renal transplantation are highly morbid. Even with modest decreases in urinary complications prophylactic ureteral stent placement is financially advantageous.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analysis of Variance
  • Anastomosis, Surgical / adverse effects
  • Anastomosis, Surgical / methods
  • Cost-Benefit Analysis
  • Female
  • Follow-Up Studies
  • Health Resources / economics
  • Health Resources / statistics & numerical data*
  • Hospital Costs*
  • Humans
  • Kidney / surgery
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / methods
  • Male
  • Patient Readmission / economics
  • Postoperative Complications / economics
  • Postoperative Complications / prevention & control
  • Prospective Studies
  • Registries
  • Risk Assessment
  • Statistics, Nonparametric
  • Stents / economics*
  • Ureter / surgery
  • Ureteroscopy / economics*
  • Ureteroscopy / methods
  • Urinary Tract Infections / economics
  • Urinary Tract Infections / prevention & control
  • Utilization Review / economics