The management of urethral stricture after kidney transplantation

Xie, Linlin; Lin, Tao; Wazir, Romel; Wang, Kun‐Jie; Lu, Yiping

doi:10.1007/s11255-014-0798-7

Cited by 8 publications

(8 citation statements)

References 8 publications

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“…The amount of time for the urethral stricture to develop was 2e7 months (average, 4.4 mo). There was an increase in postoperative Qmax values [7]. As mentioned in this study, urethral stricture is one of the complications following renal transplantation.…”

Section: Discussionsupporting

confidence: 61%

Effects of Urethral Stricture on Allografts in Kidney Transplantation

Gökçe

Kaya

Kara

et al. 2015

Transplantation Proceedings

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Section: Discussionsupporting

confidence: 61%

Effects of Urethral Stricture on Allografts in Kidney Transplantation

Gökçe

Kaya

Kara

et al. 2015

Transplantation Proceedings

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“…Urethral strictures may be associated with iatrogenic urethral injury, prolonged catheterization time and urinary tract infection. Therapeutic options include urethral dilation, endoscopic urethrotomy or urethra reconstruction [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Urological complications after renal transplantation - a single centre experience

Krajewski

Dembowski

Kołodziej

et al. 2016

CEJU

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IntroductionUrological complications after renal transplantation occur in between 2.5% and 30% of all graft recipients. The aim of the study was to present 7 years of experience in urological treatment of patients with a transplanted kidney. We aimed to identify retrospectively late urological complications in renal transplant recipients at a single center and analyze the treatment modalities and their outcome.Material and methodsBetween January 2008 and December 2014, a total of 58 patients after KTX were treated in the Department of Urology because of post-transplant urological complications that occurred during follow-up at the Transplant Outpatient Department. Retrieved data were analysed in retrospectively.ResultsIn the group of 38 patients with ureteral stenosis (Clavien grade III), 29 patients underwent endoscopy, 8 open surgical procedures and one both endoscopic and open operation. Ten patients were admitted with symptomatic lymphocoele (Clavien III), of which 9 were successfully treated with drainage and one with surgical marsupialization. Because of urolithiasis in the grafted kidney (Clavien grade III), 4 patients were treated with ureterorenoscopic lithotripsy (URSL) and one only with the extracorporeal shock wave lithotripsy (ESWL) procedure. Five urethral strictures plasties and one graftectomy because of purulent pyelonephritis were also conducted. The average age in the group of recipients who experienced urologic complications was similar (46.1 vs. 47.8) to those without complications. There was no vesicoureteral reflux or ureteral necrosis requiring surgical intervention, no graft loss and death related to urological complication and treatment.ConclusionsMost complications could be successfully treated with endourological procedures. The kidney function improved in the majority of patients.

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“…This differs from Xie et al, which reported a mean time from transplant to urethral stricture of 4.4 months (range 2-7 months), and Gökçe et al, which reported a time from transplant to urethrography and cystoscopy of 17.5 months (range 1-85 months). 9,11 At our centre, all RTRs had their ureteric stent removed via office cystoscopy 6-8 weeks after transplant surgery. Stent removal is typically the first in-person follow-up appointment most transplant patients have with transplant urology, which is likely when concerns regarding stricture-related symptoms would be first discussed, or else found incidentally on cystoscopy.…”

confidence: 99%

“…10 Patients with postoperative strictures generally present with dysuria, frequency, or hydronephrosis. 11 To the best of our knowledge, no research has been carried out to described postoperative urethral strictures in RTRs using a Canadian population. The objective of this study was to characterize urethral stricture disease in male RTRs from a single METHODS A single-center retrospective chart review was conducted on adult male RTRs (aged 19 years and older) who received a renal transplant at Vancouver General Hospital (VGH) between October 1, 2009 and October 1, 2019, and who developed a postoperative urethral stricture.…”

Section: Introductionmentioning

confidence: 99%

De novo urethral stricture disease in renal transplant recipients

Wong

Keyes

Harriman

et al. 2023

CUAJ

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Introduction: With routine catheterization and low urine output pre-transplant, renal transplant recipients (RTRs) may be at risk of urethral stricture disease post-transplant. The objective of this study was to characterize new urethral stricture disease in males following renal transplant. Methods: Retrospective chart review was carried out on all male RTRs at Vancouver General Hospital who developed urethral strictures from October 2009–2019. Descriptive analyses were conducted on patient characteristics. Comparative analyses against non-stricture RTRs were carried out. Results: Of 636 RTRs, 18 (2.8%) developed a postoperative urethral stricture. Median time from transplant to stricture discovery was 56 days (range 8–618 days). One-third of stricture patients had prior risk factors for stricture formation. Post-transplant, 77.8% presented symptomatically, with 61.1% requiring intervention. Overall graft survival rate was 88.9% among the RTR stricture group; 16.7% experienced acute rejection and 22.2% had delayed graft function (DGF). There was no significant association between developing postoperative urethral stricture and urinary tract infection (Chi-squared [X2]=0.04, p=0.84; odds ratio [OR] 0.81, 95% confidence interval [CI] 0.1–6.21), DGF (X2=0.14, p=0.70; OR 0.8, CI 0.26–2.48), or acute rejection (X2=2.02, p=0.14; OR 2.55, CI 0.71–9.12). Conclusions: De novo post-transplant urethral stricture rates appear to occur at a higher rate than the general population and contribute to patient morbidity. Stricture disease should be considered post-transplantation in patients with voiding dysfunction, even if they don’t have prior risk factors. Multicenter studies should be considered to elucidate any relationship between urethral stricture and graft survival.

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The management of urethral stricture after kidney transplantation

Abstract: Urethral strictures after kidney transplantation are rare, and they can be safely and effectively treated by urethral dilation, internal urethrotomy or urethra reconstruction. Avoiding iatrogenic injury and shortening catheterization time may help reduce the risk of this complication.

Cited by 8 publications

References 8 publications

Effects of Urethral Stricture on Allografts in Kidney Transplantation

Effects of Urethral Stricture on Allografts in Kidney Transplantation

Urological complications after renal transplantation - a single centre experience

De novo urethral stricture disease in renal transplant recipients

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