Background: Patients who have undergone renal transplant may have a concomitant benign prostatic hyperplasia (BPH), a condition that can potentially hinder the recovery of the renal graft and necessitate surgical intervention. However, endoscopic treatment of BPH should be performed carefully because of the associated perioperative risks. We aimed to systematically assess the factors affecting surgical indications and perioperative outcomes of BPH surgical treatment in renal transplantation (RT) recipients. Methods: A systematic literature search was performed on January 28, 2023, using Scopus, PubMed, and EMBASE with no date limit. Preclinical and animal studies, reviews, letters to the editor, case reports, and meeting abstracts were excluded. Results: Eighteen articles were accepted and included. Clinical BPH has a high incidence rate after RT, particularly in elderly men. Secondary events associated with BPH, such as acute urinary retention and urinary tract infections, can lead to a gradual decline of renal graft function and patient survival. BPH procedure can prevent these events and guarantee improvements in serum creatinine levels, voiding parameters, and lower urinary tract symptoms. When the urine culture is negative, the endoscopic procedure of the prostate may be performed within 1 month of the initial procedure, particularly in older patients, more prone to develop voiding dysfunction. Alternatively, a transurethral incision of the prostate may be recommended for patients with smaller prostates who wish to preserve ejaculatory function. Data on comparative BPH surgical procedures are lacking. Conclusions: BPH procedure should be offered in RT recipients who develop bladder outlet obstruction owing to BPH. Endoscopic treatment should be performed after a few weeks from RT to avoid further graft deterioration.

中文翻译：

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肾移植受者良性前列腺增生手术治疗的最新证据：系统评价。

背景：接受肾移植的患者可能伴有良性前列腺增生（BPH），这种情况可能会阻碍肾移植物的恢复并需要手术干预。然而，由于相关的围手术期风险，BPH 的内镜治疗应谨慎进行。我们的目的是系统评估影响肾移植（RT）受者 BPH 手术治疗的手术指征和围手术期结局的因素。方法：使用 Scopus、PubMed 和 EMBASE 于 2023 年 1 月 28 日进行系统文献检索，无日期限制。临床前和动物研究、评论、给编辑的信、病例报告和会议摘要被排除在外。结果：18篇文章被接受并纳入。放疗后临床 BPH 的发病率很高，尤其是老年男性。与 BPH 相关的继发事件，如急性尿潴留和尿路感染，可导致肾移植功能和患者生存率逐渐下降。BPH 手术可以预防这些事件，并保证改善血清肌酐水平、排尿参数和下尿路症状。当尿培养呈阴性时，前列腺内窥镜检查可在初次检查后1个月内进行，尤其是老年患者，更容易出现排尿功能障碍。或者，对于希望保留射精功能的前列腺较小的患者，可能会建议进行经尿道前列腺切口。缺乏比较 BPH 手术程序的数据。结论：对于因 BPH 导致膀胱出口梗阻的 RT 受者应进行 BPH 手术。内镜治疗应在放疗几周后进行，以避免移植物进一步恶化。