Impact of ureteric stent diameter on stent-related symptoms and early outcomes after kidney transplantation: A randomised controlled trial

Objective: The aim of this study is to evaluate the impact of ureteric stent diameter on stent-related symptoms and early urological complications in kidney transplant recipients. Patients and Methods: A single-centre randomised controlled trial that enrolled 70 kidney transplant recipients to receive either a 4.8 Fr or 6 Fr ureteric stent allocated at a 1:1 ratio was conducted. Stent-related symptoms and patient-reported outcomes were assessed using the Ureteral Stent Symptom Questionnaire (USSQ) and a visual analogue scale (VAS) for pain. Early postoperative complications—including urinary leakage, ureteric obstruction and urinary tract infection (UTI)—were recorded. Results: The 4.8 Fr stents were associated with significantly fewer stent-related symptoms and lower USSQ scores than 6 Fr stents (47.0 ± 4.5 vs. 53.9 ± 4.2; p < 0.001). Patients who received a 4.8 Fr stent experienced lower pain intensity than those who received a 6 Fr stent (VAS 1.4 ± 0.7 vs. 2.2 ± 0.8; p < 0.001). Rates of urinary leakage, ureteric obstruction and UTI were comparable between the two groups. Conclusion: The 4.8 Fr ureteric stents reduce stent-related symptoms and postoperative pain while demonstrating a similar early safety profile to 6 Fr stents. These findings support the use of smaller-calibre stents to improve postoperative comfort following kidney transplantation.