Department of Urologic Sciences
University of British Columbia
Characterizing renal transplant recipients with urethral strictures
Julie Wong1, David I. Harriman1, Mark K. Nigro1, Christopher Y. Nguan1.
1Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
Introduction: Urethral strictures are a relevant cause of male bladder outlet obstruction. With a history of catheterization and low urine output (UO) pre-transplant, many renal transplant recipients (RTRs) may be at risk of urethral stricture disease post-transplant. Little research has been done regarding the prevalence of urethral strictures in Canadian RTRs. The objective of this study is to characterize urethral stricture disease in RTRs from a high-volume Canadian transplant centre.
Methods: This is a single-centre retrospective chart review analysing the demographics of RTRs who had a urethral stricture pre- or post-kidney transplant. Data was extracted from patient charts and descriptive analyses were conducted.
Results: Of the 1037 patients who underwent renal transplant at our centre from October 2009-October 2019, 23 (2.22%) were found to have urethral stricture. Analysis of these patients showed median age of 55 years, with 34.8% living donor transplants. Pre-transplant, 17.4% were anuric while 60.8% had UO of <1L. 26.1% experienced delayed graft function, and 17.4% had acute rejection. 3 had known urethral strictures pre-transplant, 2 had strictures found at time of transplant, while 18 had strictures discovered post-transplant. 44.4% of these patients had recurrent strictures post-transplant. Of the post-transplant stricture patients, 11.1% had post-operative retention and 5.6% had post-operative UTI. Median time between transplant and cystoscopy showing stricture was 92 days (range 8-618). Stricture treatment involved 15 dilations, 8 urethrotomies, and 9 urethroplasties, with 7 patients requiring no intervention.
Conclusions: This study is one of the largest to characterize the incidence of urethral strictures in RTRs. It showed a prevalence of 2.22%, compared to a population prevalence of 0.9%. Urethral strictures are an important complication to monitor for in RTRs, and further research should be done to investigate the effect on transplant outcomes.
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