Presented by: Cai Tang PhD
West China Hospital

Introduction

The aim of this prospective study was to assess the safety and effectiveness of endoscopic treatments for ureteral strictures after kidney transplantation (KT).

Materials

We prospectively collect clinical characteristics from 68 patients who received endoscopic treatments for ureteral strictures after KT from January 2019 to March 2022. The hydronephrosis volume, serum creatinine, urea nitrogen levels and eGFR before and after operation were collected. Paired T test was used to compare continuous data before and after operation, and p < 0.05 indicated statistically significant differences.

Results

,

Three different types of techniques were selected according to the different conditions of ureteral strictures after KT. Over a mean follow-up time of 22.9 months (range 6–38 months), the overall success rate of the technique was 88.2% (60/68). The success rate of the type one (97.3%) was significantly higher than type two (77.8%) or type three (76.9%). The volume of hydronephrosis (64.4±79.4 VS 43.9±53.3 cm3, P=0.023) , the blood creatinine level (105.5±49.9 VS 90.4±55.5 μmol/L, P=0.021) and urea nitrogen level (6.6±3.0 VS 5.4±2.5 mmol/L, P=0.0001) decreased significantly after surgery. The level of serum eGFR was elevated from 49.5±16.6 ml/min/1.73 m2 preoperatively to 64.4 ± 17.5 ml/min/1.73 m2 postoperatively. Complications of surgery include hematuria (17.6%), pain (14.7%), urinary tract infections (14.7%) and lower urinary tract symptoms (7.4%). The incidences of stents migration, occlusion, and encrustation were 14.7%, 4.4%, and 2.9%, respectively.

Conclusion

Systemic endoscopic treatments were found to be safe and effective for ureteral strictures after KT with a long follow-up time. This technique provides a new choice for the treatment of strictures after KT.

Funding

None

Co-Authors

JiXiang Chen, PhD
West China Hospital

XiaoShuai Gao, PHD
West China Hospital

Xin Wei, PHD
West China Hospital