Endourological Management of Ureteral Stricture in Patients with Renal Transplant- A Systematic Review of Literature.
Caamina, L., et al.Journal of Endourology 2024 [record in progress].
Aims
This study aimed to explore the different endourological treatment options for treating ureteral stricture in renal transplant patients.
Interventions
Five electronic databases were searched, including EMBASE, MEDLINE, SCOPUS, Google scholar and the Cochrane library. Two independent reviewers selected studies for inclusion and extracted data. The methodological quality of the included studies was assessed using the RoB 2 and ROBINS – I tools.
Participants
19 studies were included in the review.
Outcomes
The main outcomes of interest included identification of techniques to resolve hydronephrosis or to treat ureteral stricture, their success rate and complications.
Follow-up
N/A
CET Conclusions
This systematic review aimed to investigate the available endourological options for the treatment of ureteral stricture following renal transplantation. A total of 19 studies were included, all of which were retrospective in nature--this is likely to have introduced bias. No meta-analysis was performed due to heterogeneity between studies, and absence of randomised controlled trials and standardised outcomes. While the variability among studies and limitations in data provided regarding use of antegrade or retrograde approaches as well as robotic approaches means that it is difficult to draw firm conclusions; nevertheless, the authors conclude that minimally invasive endourological techniques are safe and show long-term benefits and can therefore be used as the first-line treatment of ureteral stricture in patients with renal transplant. Since success rates are influenced by factors such as the specific technique used, the timing of diagnosis and intervention, and the characteristics of the ureteral stricture, the authors recommend establishing a classification system which may help in choosing the best treatment approach. Additionally, developing standardised protocols and conducting research with a prospective design may help in addressing knowledge gaps.
Trial registration
N/A