Antegrade percutaneous dilation of ureteral strictures after kidney transplantation

Oosterhof, G.O.N.; Hoitsma, Andries J.; Debruyne, F.M.J.

doi:10.1007/bf02425970

Cited by 11 publications

(10 citation statements)

References 16 publications

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“…Peregrin et al reported successful dilation in 96 YO of 23 patients, but long-term success in only 50% [9]. Similar results have been reported by others [5, 8,10,111. The main disadvantage of this method is the uncontrolled destruction of ureteral and periureteral tissue by the dilation.…”

Section: Discussionsupporting

confidence: 66%

Treatment of transplant ureteral stenosis with Acucise endoureterotomy

Gross

Seseke

Lorf

et al. 1998

Transplant International

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Section: Discussionsupporting

confidence: 66%

Treatment of transplant ureteral stenosis with Acucise endoureterotomy

Gross

Seseke

Lorf

et al. 1998

Transplant International

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“…In the first line percutaneous or endoscopic dilation is recommended, success rates are up to 85 YO [2,11,14,19,23,31].…”

Section: Resultsmentioning

confidence: 99%

Native pyeloureterostomy after kidney transplantation: experience in 48 cases

Schult¹,

Kuster²,

Kliem³

et al. 2000

Transplant Int

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Necrosis and stenosis of the ureter are severe complications after kidney transplantation and occur with mean incidence of 2,9-13,4 %. Several surgical techniques like simple nephrostomy or complex urinary tract reconstruction have been applied for repair. In this study, our experience with native pyeloureterostomy (NPUS) using the native ureter is presented. Between March 1978 and June 1996, 2592 kidney transplantations were performed in our institution. In 48 patients (1,9 YO), secondary urinary tract reconstruction by NPUS was necessary. These patients were evaluated retrospectively by review of the case notes. At the time of operation the mean age was 45 f 14 years. Indications for NPUS were distal ureteral stenosis (n = 29), necrosis (n = 17), bleeding (n = 1) or iatrogenic lesion of the ureter (n = 1). The mean time period between transplantation and urinary tract reconstruction was 20 + 23 days (range: 1-90 days) for necrosis and 404 ? 637 days (range: 14-2385 days) for stenosis. A pyeloureterostomy was technically feasible in all patients using the recipient's ipsilateral ureter. In 40 out of 48 patients the graft developed a normal function postoperatively (follow up: 39 f 48 months). A graft nephrectomy was necessary only in one patient, because of complete pyelonnecrosis 6 days after NPUS. Two grafts were lost due to acute rejection. Data of five patients were not available > 15 years after successful reconstruction. We can conclude that NPUS is a safe and simple rescue technique for the treatment of distal ureteral complications after kidney transplantation. Therefore, this technique should be the therapy of choice when secondary reconstruction by re-ureteroneocystostomy is not possible.

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“…In cases of confined ureteral obstruction, especially stricture of the ureter-bladder anastomosis, a percutaneous antegrade di lation or incision of the strictured area may be done. Our limited experience with 6 patients was good in 4, with now a mean follow-up of 24 months [11].…”

Section: Discussionmentioning

confidence: 99%

“…Treatment of both conditions is mainly surgical [2,13]. In selected cases of confined ureteral stricture a percutaneous endourologic treatment is also possible [4,6,11].…”

mentioning

confidence: 99%

Diagnosis and Treatment of Urological Complications in Kidney Transplantation

Oosterhof

Hoitsma²,

Witjes³

et al. 1992

Urol Int

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Between January 1973 and January 1990 we carried out 1,038 kidney transplantations using a transvesical end-to-side implantation of the ureter in the bladder without an antireflux mechanism. Moreover, 30 transplantations were done in 26 patients with a urinary diversion. We examined the urological complications in these 1,068 consecutive transplants. Urinary leakage and obstruction were the two main urological posttransplant complications. Severe leakage occurred in 21 patients (2.0%), and was treated by open surgery; 2 patients had a urinary diversion. The treatment of choice is a pyeloureterostomy (anastomosis between the transplant renal pelvis and the native ureter). There were 35 patients (3.3%) with severe ureteral obstruction of whom 5 had a urinary diversion. In 30 patients open surgical treatment of the obstruction was necessary and in 7 patients a percutaneous endourologic treatment was done (dilatation of a confined ureteral stricture in 6 patients and percutaneous stone treatment in 1). The postoperative mortality in the patients treated for leakage or obstruction was low: 4 patients (7%) died, 3 of septicemia due to leakage and 1 of pulmonary embolism after repair of the obstruction. The results of surgical treatment were good. The graft survival after 2 years in the group of urologically complicated transplants was 68% for the patients with leakage and 80% for those with obstruction. The 2-year graft survival in the patients without complications was 67% and 71 % for the patients with a urinary diversion. We conclude from these results that urological complications after renal transplantation can be treated successfully by surgical (or percutaneous) correction.

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Antegrade percutaneous dilation of ureteral strictures after kidney transplantation

Cited by 11 publications

References 16 publications

Treatment of transplant ureteral stenosis with Acucise endoureterotomy

Treatment of transplant ureteral stenosis with Acucise endoureterotomy

Native pyeloureterostomy after kidney transplantation: experience in 48 cases

Diagnosis and Treatment of Urological Complications in Kidney Transplantation

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