***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Introduction : There is debate on renal graft stenting during ureteroneocystostomy , patients with ureteral stents  may encounter several complications such as encrustation , stent crustation which can lead to loss of kidney , and complications related to stent extraction : pain and UTI increasing related to cystoscopy for stent extraction accompanying excess expenses . This study design ed to reduce complications related to stent extraction . Material and Methods : 90 patients prepared for renal transplantation during 1 year r and omly classified to groups , study group : patients with attached stent to Foley catheter  , control group : patients with conventional technique ( stent separated from Foley ) then in their follow up ; UTI , stent crustation , luts severity compared to each other . Results : Second week and fourth week UTI reported 25.6 % , 2.3 % in study group versus 34.9 % , 4.7 % in control group ( P value 0.48 and 0.5 ) . Urinary leakage was 3.3 % overall , that all of them occurred in separate stent group , 37.5 % vs. 0 % in the linked stent group . Stent crustation in separate stent was 25 % compared with 0 % in the linked stent . Conclusion : Low complications rate in linked stent group , despite the lack of significant statistical differences , but indicate the effectiveness and success of the new technique OBJECTIVES There are studies that show that double J stenting ( DJS ) increase BK nephropathy ( BKN ) 4 fold . DJS may cause vesicoureteral reflux ( VUR ) with normal bladder contraction . The aim of this study is to comparison risk of BKN , urinary tract infections ( UTI ) and postoperative urologic complications with the use DJS with anti-reflux device ( ARD-DJS ) and st and art double J stent ( St-DJS ) . Matherial and methods : Ninety patients ( male/female : 50/40 ) that had undergone kidney transplantations in Diyarbakır Training and Research Hospital and Dicle University , Faculty of Medicine Hospital between January 2012 and April 2015 were enrolled in the study . Demographic data , immunosuppression protocol s , presence of rejection , graft loss , postoperative urologic complications , UTI , plasma BK levels of the patients were evaluated retrospectively . RESULTS Median and IQR follow up time for ARD-DJS and St-DJS patients were 14 ( 12 - 18 ) months and 25 ( 16 - 30 ) months respectively . Five cases ( 5.5 % ) had BK viremia ( P=0.025 ) . All 5 cases with BK viremia were St-DJS users . CONCLUSION As a result for postoperative UTI and postoperative urinary complication risk there were no statistically significant difference between ARD-DJS use and St-DJS use during ureteral anastomosis . BKN univariate analysis were significantly less than those st-DJS used . Risc factors were evaluated . But results were not statistically significant in the logistic regression analysis . We think that to demonstrate this benefit , we need r and omized controlled studies with more patients and longer follow up Asymptomatic bacteriuria ( AB ) is frequent among kidney transplant patients during the first year post transplantation . Currently , there are no clear guidelines for the antibiotic treatment of AB among these patients . We examined the outcomes of treatment versus no treatment of AB in kidney transplant patients during the first year post transplantation . A retrospective cohort study including adults > 16 years of age transplanted in one center between 1/2004 and 12/2010 was undertaken . The primary outcome was a composite of hospitalization for symptomatic urinary tract infection ( UTI ) or more than 25 % reduction in the estimated glomerular filtration rate ( eGFR ) 30 days after the documentation of AB . Secondary outcomes included symptomatic UTIs following the episode of AB , persistent recurrent AB , total days in hospital , mortality , adverse events , and resistance development .  A total of 112 patients with AB fulfilled the inclusion criteria . Twenty-two patients received antibiotic treatment ( 19.6 % ) , while 90 patients did not . The primary outcome occurred in 4/22 ( 18.2 % ) of the treated patients versus 5/90 ( 5.6 % ) of the untreated patients [ odds ratio ( OR ) = 3.78 , 95 % confidence interval ( CI ) 0.9–15 ] . The risk of developing symptomatic UTI after AB was almost three times higher ( p < 0.05 ) and the total number of hospitalization days at 6 months post AB was also significantly higher ( p < 0.026 ) in the treated group . No patient died during the study period . UTI caused by bacteria resistant to the antibiotic used for the treatment of AB occurred in 36 % of the treated patients . We observed no benefit for the antibiotic treatment of AB in the short- and long-term follow-up . A prospect i ve observational study is needed INTRODUCTION Duration of retaining ureteric stent in kidney transplantation is still controversial . Our study aim ed to compare healthcare expenditures in kidney transplant recipients with early or routine ureteric stent removal .  METHODS This study was a post hoc analysis of data from a single-center parallel r and omized controlled open-label study . Ninety patients who underwent kidney transplantation at a university-based hospital in Thail and from April 2010 to January 2011 were enrolled . Patients were r and omized to early ureteric stent removal ( 8 days ) or routine ureteric stent removal ( 15 days ) after kidney transplantation . The costs of direct health care associated with kidney transplantation , urologic complication , and urinary tract infection ( UTI ) within the postoperative period among the 2 groups were compared . RESULTS Seventy-four patients ( 58 % living donor ) fulfilled the r and omized criteria ( early removal , n = 37 ; routine removal , n = 37 ) . By intention-to-treat analysis , incidence of UTI in early stent removal was less than the routine stent removal group ( 15/37 , 40.5 % vs 27/37 , 72.9 % ; P = .004 ) . Urologic complication showed no significant difference between the early and routine groups ( 4/37 vs 2/37 ; P = .39 ) . The cost-benefit analysis of early over routine stent removal was 2390 United States dollars ( USD ) per patient ( 11,182 vs 8792 USD ) . Presence of UTI significantly increase the hospitalization cost of 5131 USD per patient ( mean cost = 12,209 vs 7078 USD ; P < .001 ) . CONCLUSION UTI in the early post-kidney transplantation period increases healthcare cost .  Early ureteric stent removal can reduce UTI and reduce hospitalization cost . This approach shows cost-benefit in the early management of kidney transplant recipients PURPOSE We evaluated the impact of the routine use of Double-J stents for decreasing urological complications in living related renal transplantation at a single center during the last 10 years . MATERIAL S AND METHODS Our 3-phase longitudinal study included 670 consecutive living related renal transplants from 1989 to 1998 . In phase 1 from 1989 to 1993 a stent was introduced as and when required in only 15 of 170 patients . In phase 2 from January 1994 to April 1995 we r and omized 57 and 43 cases to stenting and no stenting , respectively . The stent was removed after 4 weeks . In phase 3 from May 1995 to December 1998 all patients received a stent , which was removed 10 to 14 days just before discharge home . We review ed urological complications at various time frames to determine the impact of routine Double-J stenting on decreasing urological complications . RESULTS In phase 1 the major ureteral complication rate was 8.8 % , which decreased to 3 % in phase 2 when half of our cases were stented . In phase 3 there was only 1 ureteral complication ( 0.04 % ) in 400 patients , of whom all received a stent . The overall ureteral complication rate in nonstented and stented cases was 8.5 % ( 18 of 213 ) and 0.22 % ( 1 of 457 ) . There was no difference in urological complications or stent related problems whether the stent was removed at 4 or 2 weeks . However , stent removal at 2 weeks eliminated the possibility of a forgotten stent , avoided repeat hospitalization for stent removal and decreased the cost . Routine stenting was cost-effective and almost eliminated urological complications . CONCLUSIONS Routine Double-J stenting prevents ureteral complications . Early removal at 2 weeks is advisable . The short duration of stenting is effective and saves the cost of repeat hospitalization at a later date Prophylactic ureteric stenting has been shown to reduce ureteric leaks and collecting system obstruction following renal transplantation and is in widespread use . However , the optimal time for removal of ureteric stents after renal transplantation remains unclear . Aim of this study was to compare the result of early versus late removal of ureteric stents after kidney transplantation of the laparoscopically retrieved live related donor grafts . Eligible patients were live donor kidney transplant recipients with normal urinary tracts . All recipients underwent extravesical Lich – Gregoire ureteroneocystostomy over 4F/160 cm polyurethane double J stents by a uniform technique . They were r and omized on seventh postoperative day for early removal of stents on postoperative day 7 ( Group I ) , or for late removal on postoperative day 28 ( Group II ) . The incidence of urinary tract infections , asymptomatic bacteriuria , and urological complications were compared . Between 2007 and 2009 , 130 kidney transplants were performed at one centre of which 100 were enrolled for the study , and 50 each were r and omized into the two groups . Donor and recipient age , sex , native renal disease , immunosupression , number of rejection episodes , and antirejection therapy were similar in the two groups . The occurrence of symptomatic urinary tract infection during the follow-up period of 6 months was significantly less in the early stent removal group [ 5 out of 50 ( 10 % ) in Group I , vs 50 out of 15 ( 30 % ) in Group II , P=0.02 ] . Asymptomatic bacteriuria was documented in 2 out of 50 ( 4 % ) in Group I and 4 out of 50 ( 8 % ) in Group II ( P=0.3 ) . There was no statistically significant difference in the rate of ureteric leak , ureteric obstruction , or hematuria in the two groups ( P=1.0 ) . We conclude that , in kidney transplant recipients of laparoscopically retrieved live donor grafts , early stent removal at the end of first week reduces the incidence of urinary tract infection without increasing the rate of urine leak or ureteric obstruction 
    Output:
    
Early removal of ureteral stents  after renal transplant may be associated with reduced rates of UTI and ureteral stenosis .