The management of urethral stricture after kidney transplantation

To investigate the incidence and causes of urethral stricture after kidney transplantation, as well as analyze its diagnosis, treatment and prevention. 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. 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. 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.