You have accessJournal of UrologyCME1 Apr 2023PD31-03 EFFECTIVENESS OF ENDOUROLOGICAL MANAGEMENT OF URETERAL STENOSIS IN KIDNEY TRANSPLANT PATIENTS: EAU-YAU KIDNEY TRANSPLANTATION WORKING GROUP COLLABORATION Alejandra Bravo-Balado, Angelo Territo, Iulia Andras, Riccardo Campi, Alessio Pecoraro, Vital Hevia, Thomas Prudhomme, Michael Baboudjian, Andrea Gallioli, Isabel Sanz, Jorge Robalino, Paolo Verri, Mathieu Charbonnier, Romain Boissier, and Alberto Breda Alejandra Bravo-BaladoAlejandra Bravo-Balado More articles by this author , Angelo TerritoAngelo Territo More articles by this author , Iulia AndrasIulia Andras More articles by this author , Riccardo CampiRiccardo Campi More articles by this author , Alessio PecoraroAlessio Pecoraro More articles by this author , Vital HeviaVital Hevia More articles by this author , Thomas PrudhommeThomas Prudhomme More articles by this author , Michael BaboudjianMichael Baboudjian More articles by this author , Andrea GallioliAndrea Gallioli More articles by this author , Isabel SanzIsabel Sanz More articles by this author , Jorge RobalinoJorge Robalino More articles by this author , Paolo VerriPaolo Verri More articles by this author , Mathieu CharbonnierMathieu Charbonnier More articles by this author , Romain BoissierRomain Boissier More articles by this author , and Alberto BredaAlberto Breda More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003324.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureteral stenosis (US) in kidney transplant (KT) recipients is associated with poorer long-term graft survival. Surgical repair is the standard of care, and endoscopic treatment may represent an alternative for stenosis<3 cm. We aimed to determine the effectiveness and safety of endourological management of US in KT patients and predictors of success. METHODS: A retrospective multicenter study was conducted in four European referral centers, including all KT patients with US managed endoscopically between 2009 and 2021. Clinical success was defined as the absence of upper urinary tract catheterization, surgical repair or transplantectomy during follow-up. RESULTS: A total of 44 patients were included. The median time to US onset was 3.5 months (IQR 1.9-10.8), the median length of stricture was 10 mm (IQR 7-20). Management of US involved balloon dilation and laser incision in 36 (82.5%) and 5 (13.2%) cases, respectively. Clavien-Dindo complications were infrequent (10%) and only one Clavien ≥III complication was reported. Clinical success was 61% at last follow-up visit (mean of 44.6% months). In the univariate analysis, sharp stenosis (vs. flat/concave) was associated with treatment success (RR 0.39, p 0.04), while late onset stenosis (>3 months post KT) with treatment failure (RR 2.00, p 0.02). Figure 1 shows two antegrade pyelograms of ureteral stenosis: A. Sharp or duckbill shape. B. Flat or concave shape. CONCLUSIONS: The success rate of the endoscopic management of ureteral stenosis in KT is 61%. Considering this technique is associated with a minimal level of complications, we conclude that in this setting an endoscopic treatment could be proposed first. Patients with a 10 mm sharp US diagnosed<3 months post KT are the best candidates. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e901 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alejandra Bravo-Balado More articles by this author Angelo Territo More articles by this author Iulia Andras More articles by this author Riccardo Campi More articles by this author Alessio Pecoraro More articles by this author Vital Hevia More articles by this author Thomas Prudhomme More articles by this author Michael Baboudjian More articles by this author Andrea Gallioli More articles by this author Isabel Sanz More articles by this author Jorge Robalino More articles by this author Paolo Verri More articles by this author Mathieu Charbonnier More articles by this author Romain Boissier More articles by this author Alberto Breda More articles by this author Expand All Advertisement PDF downloadLoading ...