Simultaneous antegrade-retrograde endoscopic procedures for the placement of thermo-expandable metallic stents in the treatment of ureteral stenosis in kidney transplantation patients: A cohort study.

ObjectiveTo evaluate the efficacy and safety of simultaneous antegrade-retrograde endoscopic rendezvous procedure for thermo-expandable metallic stent (Memokath 051) placement in treating post-kidney transplantation ureteral stenosis.MethodsA retrospective single-arm cohort study was conducted in six female patients with distal ureteral strictures after kidney transplantation treated between 2022 and 2024. A dual-endoscope technique was used for stent deployment. Surgical parameters, laboratory indicators, and complications were recorded, with a follow-up period of 1-20 months. Paired t-tests or Wilcoxon tests were applied for statistical analyses.ResultsAll stents were successfully placed, with a mean operative time of 173.0 min and mean hospital stay of 8.8 days. Hydronephrosis was significantly relieved in all patients. Postoperative estimated glomerular filtration rate was significantly higher than the preoperative rate (p = 0.04), whereas no significant differences were found between the pre- and postoperative creatinine levels or leukocyte counts. A mild but clinically insignificant hemoglobin drop occurred on postoperative day 1 (p = 0.02). One patient experienced stent migration that was successfully repositioned, and another developed recurrent urinary tract infections that were controlled using antibiotics. All stents remained patent at the final follow-up.ConclusionThe simultaneous antegrade-retrograde endoscopic approach for Memokath 051 placement appears to be a safe and effective minimally invasive option for post-transplant ureteral stenosis; this finding warrants confirmation in further large-scale multicenter studies.