Incidence and management of ureteric stricture in renal transplantation: A local center with ten years of experience

Background and objective: Renal transplantation for patients with end-stage renal disease gives better long-term survival results and a better quality of life in comparison with maintenance dialysis. However, some general and urological complications may occur following kidney transplantation. One of those complications is ureteral stricture, but the harm of renal transplant can be avoided when treated in an accurate and timely manner. This study is carried out to determine the incidence of ureteral stricture of renal transplantation, and to appropriately diagnose and treat the conditions. Methods: A retrospective study extended from July 2011 to February 2021. In this period, 1840 renal transplant performed by our team in Rizgary teaching and Zheen international hospitals, all from living donors. Results: Among 1840 kidney transplant surgery, 17 patients were only admitted as ureteral stricture post-transplant operation (0.92%) that diagnosed by high serum creatinine in association with hydroureteronephrosis. Hydronephrosis subsided and renal function tests nearly normalized after drainage of transplanted kidney with percutaneous nephrostomy tube. Anastomosis site stricture was observed in 16 patients (94.1%), they were treated by ureteral re-implantation. DJ-stenting and upper ureteric stricture was observed in only one patient (5.9%) that treated through pyeloplasty technique. Conclusion: Surgical treatment is the best choice of patients with ureteral stricture, post renal transplantation. For low grade stricture, endoscopic treatment may be offered although the rate of success is not high.