LAUSR

BACKGROUND Kidney transplantation (KT) is the treatment of choice for end-stage kidney disease. The double-J-stent (DJS) has been used to prevent urological complications (UC) but it requires cystoscopy extraction. The novel magnetic black star (MBS) stent provided with a customized retrieval device (9 or 15 Fr), has been developed to spare cystoscopy. Scope of the paper is to analyze MBS in 100 consecutive KTs. METHODS We report a retrospective analysis of 100 consecutive KT performed between April 2015 and September 2018 using MBS (4.8 Fr, 15 cm) to protect Lich-Gregoir ureteroneocystotomy. MBS was removed 4 weeks after KT by either the 9 Fr (61 cases) or the 15 Fr (39 cases) retrieval device. RESULTS Intraoperative MBS insertion was straightforward in all cases and its extraction was carried out in the outpatient setting in 93 patients. Extraction time was < 30 seconds in 45/61 patients (73.8%) and in 38/39 patients (97.4%) using the 9 Fr and the 15 Fr retrieval device respectively. In 15 patients MBS removal took between 30 seconds and 3 minutes. Only 2 cases required extraction by cystoscopy. We observed 2 UC (ureteric leak and stenosis), 8 urinary tract infections (UTIs) and 9 stent-related symptoms. 7 patients experienced distressing pain according to Visual Analog Scale for Pain. CONCLUSIONS In our cohort, MBS appeared to be safe and cost-effective. We advocate its routine implementation in KT due to an easy and comfortable extraction in the outpatient setting even by non-dedicated staff, without detrimental impact on UC and UTI rates.