Abstract
Objective
To investigate the incidence and causes of urethral stricture after kidney transplantation, as well as analyze its diagnosis, treatment and prevention.
Methods
Clinical data of patients who developed urethral stricture after living-donor kidney transplantation in our center between January 2007 and June 2012 were retrospectively analyzed.
Results
Urethral stricture occurred in 8 of the 677 eligible kidney recipients (1.18 %) during the study period; the complication occurred at a mean of 4.4 months (range 2–7 months) after transplantation. Cystoscope-related iatrogenic injury and urinary tract infection seemed to be the most likely causes. In addition to frequency and dysuria, three patients had hydronephrosis and four had elevated serum creatinine levels. Urethrography showed that the urethral stricture was anterior in two patients and posterior in the remaining six. Two patients were treated by urethral dilation, four by internal urethrotomy and two by urethra reconstruction surgery. All patients urinated readily after treatment and four patients with impaired renal function recovered.
Conclusion
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.
Similar content being viewed by others
References
Evans RW, Manninen DL, Garrison LP et al (1985) The quality of life of patients with end-stage renal disease. N Engl J Med 312:553–559
Port FK, Wolfe RA, Mauger EA et al (1993) Comparison of survival probabilities for dialysis patients vs cadaveric renal transplant recipients. JAMA 270:1339–1343
Garcia GG, Harden P, Chapman J, World Kidney Day Steering Committee (2012) The global role of kidney transplantation. Lancet 2012(379):36–38
Tritschler S, Roosen A, Fullhase C et al (2013) Urethral stricture: etiology, investigation and treatments. Dtsch Arztebl Int 110(13):220–226
Bailey MJ, Shearer RJ (1979) The role of internal urethrotomy in the prevention of urethral stricture following transurethral resection of prostate. BJU Int 51:28–31
Dorfman B, Yussim A, Gillon G et al (1997) Conservative approach to lower urinary tract abnormalities in cadaveric renal transplantation. Transplant Proc 29:143–144
Hammarsten J, Indgvist K, Sunzel H (1989) Urethral strictures following transurethral resection of the prostate: the role of the catheter. BJU Int 63(4):397–400
Wang Y, Sebaratnam DF, Wong JCh et al (2012) Urethral stricture caused by schistosomiasis in a renal transplant recipient. Nephrology 17(2):197–198
Dong J, Lu J, Zu Q et al (2011) Routine short-term ureteral stent in living donor renal transplantation: introduction of a simple stent removal technique without using anesthesia and cystoscope. Transplant Proc 43:3747–3750
Conflict of interest
The authors declare no funding or conflict of interests.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Xie, L., Lin, T., Wazir, R. et al. The management of urethral stricture after kidney transplantation. Int Urol Nephrol 46, 2143–2145 (2014). https://doi.org/10.1007/s11255-014-0798-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-014-0798-7