학술논문

De novo urethral stricture disease in renal transplant recipients.
Document Type
Article
Source
Canadian Urological Association Journal. Oct2023, Vol. 17 Issue 10, p346-352. 7p.
Subject
*URETHRA stricture
*RESEARCH
*CONFIDENCE intervals
*PATIENTS
*KIDNEY transplantation
*RETROSPECTIVE studies
*DISEASES
*GRAFT survival
*SURVIVAL rate
*COMPARATIVE studies
*CHI-squared test
*DESCRIPTIVE statistics
*ODDS ratio
*CATHETERIZATION
*TRANSPLANTATION of organs, tissues, etc.
Language
ISSN
1911-6470
Abstract
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: A 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. [ABSTRACT FROM AUTHOR]