Faut-il mettre une sonde double J de façon systématique lors d'une transplantation rénale ?

Abstract

Protection of urinary anastomoses using a ureteral sound is a frequent option in urology but such use in a systematic manner remains debated in renal transplantation. Some consider that systematic insertion of a double J sound decreases the incidence of ureteral complications (fistula and stenosis). Others who prefer a selective use in some situations with a related risk consider that the implementation of a double J sound cannot compensate a technical defect. It is even responsible for specific complications (infections, incrustations, haemorrhages); it increases implantation costs and is useless in more than 90% of the cases. This article analyses the risks related to systematic implementation of a double J sound in Lich-Gregoir ureterovesical anastomoses for renal transplantation, together with the related costs and the infectious risk. The benefits in terms of prevention of ureteral complications are evaluated.