Urological follow-up and development of cancer after renal transplantation

被引:0
|
作者
Giessing, M. [1 ]
机构
[1] Heinrich Heine Univ Klinikum Dusseldorf, Univ Klin Urol, D-40225 Dusseldorf, Germany
来源
UROLOGE | 2015年 / 54卷 / 10期
关键词
Neoplasms; Urinary tract infection; Urethral stricture; Urinary bladder dysfunction; Immunosuppression; URINARY-TRACT-INFECTIONS; KIDNEY-TRANSPLANTATION; UROTHELIAL CARCINOMA; RAPAMYCIN INHIBITORS; BLADDER-CANCER; LIVING-DONOR; RECIPIENTS; RISK; MALIGNANCY; TUMORS;
D O I
10.1007/s00120-015-3910-4
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background. The number of renal transplant recipients is rising, as well as graft and recipient survival. The mainstay of urological follow-up is to ensure urine transport and voiding function; also, the diagnosis and treatment of urological malignancies following renal transplantats is growing in importance. As urological malignancies are one of the three most common tumors following renal transplantation (RT), meticulous and regular urological evaluation is a central part of follow-up care after RT. Recommendations. Urological evaluation following RT must ensure correct urine transport and voiding function. Transplant ureter strictures, relevant ureteral reflux and voiding dysfuntion (e.g., neurologic dysfunction, benign prostate hypeplasia) must be excluded or treated. Urinary tract infection (UTI), which can be life threatening in the immunosuppressed transplant recipient, must be diagnosed and treated consequently and for an adequate period of time. Prophylaxis of UTIs is indicated in patients with recurrent symptomatic UTI as well as in the initial 6 months following renal transplantation. Asymptomatic bacteriuria must not necessarily be treated. The incidence of urological malignancies like renal cell carcinoma, urothelial cancer of the bladder, and penile carcinoma is increased following RT, while the incidence of prostate and testis cancer is the same as in the nontransplant population. Surgical and nonsurgical treatment options do not differ from the normal population. Adaptation, cessation, or switching of the immunosuppressive regimen in case of urologic malignancy must be decided on the individual recipient basis.
引用
收藏
页码:1393 / 1401
页数:9
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