Abnormalities of Preoperative Ascending Urethrocystography and Outcomes of Living Donor Kidney Transplantation
NCT ID: NCT06735066
Last Updated: 2024-12-16
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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NOT_YET_RECRUITING
80 participants
OBSERVATIONAL
2024-12-31
2025-11-01
Brief Summary
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Detailed Description
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Ascending urethrocystography (AUC) is a key diagnostic tool to assess the integrity and functionality of the lower urinary tract . It provides detailed insights into the bladder, urethra, vesicoureteral valves, and surrounding structures, identifying any abnormalities that could pose risks during or after KT . Understanding this issue is crucial, as certain urological anomalies may predispose patients to complications such as urinary leaks, infections, or delayed graft function, potentially leading to poorer short-term outcomes .
Although AUC is used indiscriminately as a screening test for urological abnormalities, only 6% of all KT recipients may have abnormal lower urinary tract . Few studies have looked at the yield from AUC and attempted to assess objectively whether certain patients could be selected for KT based on a positive result in AUC . Accordingly, the impact of abnormalities detected in AUC on the short-term outcomes of living donor KT (LDKT) remains inefficiently studied .
This is the rationale to conduct this cohort study on patients undergoing LDKT. We hypothesize that the presence of abnormalities in AUC will influence the surgical outcomes and short-term survival rates after LDKT
Conditions
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Keywords
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Study Design
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COHORT
PROSPECTIVE
Study Groups
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Transplantation group
adult patients who underwent kidney transplantation
Ascending urethrocystography
It will be performed after instructing the patient to evacuate the bladder. A contrast agent will be infused through the urethra under fluoroscopy, using a urethral catheter or Knutson's clamp at the external urethral meatus. When the bladder is full, an anteroposterior film and two oblique films will be taken. Voiding cystourethrography will be performed as a part of this imaging examination. From this procedure, the following findings may be diagnosed:
* Upper urinary tract: Vesicoureteral reflux (VUR); laterality and degrees of VUR will be defined.
* Bladder: Capacity (defunctionalized, Small-sized or contracted bladder), neurogenic bladder, bladder diverticulum, filling defects, etc.
* Urethra: Stricture and filling defects.
Interventions
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Ascending urethrocystography
It will be performed after instructing the patient to evacuate the bladder. A contrast agent will be infused through the urethra under fluoroscopy, using a urethral catheter or Knutson's clamp at the external urethral meatus. When the bladder is full, an anteroposterior film and two oblique films will be taken. Voiding cystourethrography will be performed as a part of this imaging examination. From this procedure, the following findings may be diagnosed:
* Upper urinary tract: Vesicoureteral reflux (VUR); laterality and degrees of VUR will be defined.
* Bladder: Capacity (defunctionalized, Small-sized or contracted bladder), neurogenic bladder, bladder diverticulum, filling defects, etc.
* Urethra: Stricture and filling defects.
Eligibility Criteria
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Inclusion Criteria
* Patients with preoperative evaluation by AUC.
Exclusion Criteria
* Patients with missing relevant preoperative or postoperative data.
* Patients refusal to participate in the study.
5 Years
80 Years
ALL
No
Sponsors
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Assiut University
OTHER
Responsible Party
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Shehabeldin Alaa Ahmed Mahmoud Ahmed Saad
resident doctor at Urology department Faculty of Medicine, Assiut University
Central Contacts
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References
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John EE, Mehta S, Sohal PM, Sandhu JS. Predictors of Short-Term Outcomes in Living Donor Renal Allograft Recipients: A Prospective Study From a Tertiary Care Center in North India. Cureus. 2022 Aug 24;14(8):e28335. doi: 10.7759/cureus.28335. eCollection 2022 Aug.
Jayanth ST, Dangi AD, Mukha RP, Kumar S, Varughese S, David VG, Valson A, Chandrasingh J, Devasia A, Kekre N. Renal transplantation into optimized abnormal lower urinary tract - Impact on graft outcomes, patient survival, and complications. Indian J Urol. 2019 Jan-Mar;35(1):67-72. doi: 10.4103/iju.IJU_203_18.
Freitas PS, Alves AS, Correia PS, Dias JL. Urethrocystography: a guide for urological surgery? Diagn Interv Radiol. 2023 Jan 31;29(1):9-17. doi: 10.5152/dir.2022.21640. Epub 2022 Dec 21.
Sellers MT, Velidedeoglu E, Bloom RD, Grossman RA, Markmann JW, Naji A, Frank AM, Kass AB, Nathan HM, Hasz RD, Abrams JD, Markmann JF. Expanded-criteria donor kidneys: a single-center clinical and short-term financial analysis--cause for concern in retransplantation. Transplantation. 2004 Dec 15;78(11):1670-5. doi: 10.1097/01.tp.0000144330.84573.66.
Other Identifiers
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Kidney transplantation 2024
Identifier Type: -
Identifier Source: org_study_id