Balloon Dilation for Ureteral Strictures in Graft Kidneys

List, A; Blohmé, I; Brynger, H; Nilson, A. E.

doi:10.1097/00007890-198301000-00022

“…Different techniques are employed, among them antegrade [3] and retrograde [5] dilation, dilation with semirigid or balloon dilators [5,9,[15][16][17], incision [7], and dilation [3,6]. Dilation of short ureteral strictures has a high incidence of success, and patients with such strictures usually are the best candidates for percutaneous manipulation [2,16], although successful dilation of a long stricture has also been described [17].…”

Section: Discussionmentioning

confidence: 99%

“…Pyeloureterostomy (anastomosis between the pelvis of the transplanted kidney and the native ureter) is the treatment of choice in such cases [4,18]. For a confined stricture, percutaneous treatment may be indicated [8,9,13,15,16]. It is sometimes difficult to establish the size of the stricture since antegrade pyelography and IVU tend to underestimate the real (histologic) length of the stricture.…”

Section: Discussionmentioning

confidence: 99%

“…Since the development of percutaneous techniques, transluminal dilation of ureteral strictures has become an accepted mode of treatment for obviating a potentially complicated operation [8,9,15,16]. Patients with short strictures of the ureter are known to be the best candidates for endoscopic dilation [2], but experience with this technique in transplanted kidneys is rather limited [7-9, 13, 15, 16].…”

Section: Abstract: Endoscopic Dilation -Percutaneous Antegrade Dilationmentioning

confidence: 99%

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Antegrade percutaneous dilation of ureteral strictures after kidney transplantation

Oosterhof

¹

,

Hoitsma

²

,

Debruyne

³

1989

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Ureteral obstruction after renal transplantation is due mostly to retroperitoneal fibrosis in the area of surgical dissection, and pyeloureterostomy is the treatment of choice for such an obstruction. For confined strictures, especially at the site of the ureteroneocystostomy, endoscopic dilation may be a good alternative. Antegrade percutaneous dilation was used to treat six patients with ureteral stricture after kidney transplantation. Four patients had stricture at the ureterovesical junction, one a confined midureteral stricture, and one a secondary stricture at the site of pyeloureterostomy. Percutaneous antegrade dilation of the stricture to 14 Fr with semirigid fascial dilators and external ureteral stenting with a 12-Fr silicon splint for 6 weeks was successful in the four patients with ureterovesical junction obstruction, but not in the two other patients. Results were judged on the basis of serum creatinine concentration, renal ultrasonography, and intravenous urography (IVU). The follow-up period was 12-20 months (mean 15 months). None of the six patients died and perioperative morbidity was minimal.

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“…The 21 patients underwent a total of 28 endourologic procedures, including 9 retrograde pyelographies (6 with ureteral stenting), 13 …”

Section: Methodsmentioning

confidence: 99%

Interventional Endourologic Procedures after Renal Transplantation

Höbarth¹,

Hofbauer²,

Marberger³

1992

Journal of Endourology

0

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Interventional endourologic procedures were performed in 21 of 257 renal transplant recipients, representing a rate of urologie complications of 8.2%. Antegrade pyelography studies are the key to the diagnosis of ureteral obstruction or leakage. Retrograde manipulations failed in 57%, especially in the early postoperative period when the ureteroneocystostomy was found to be grossly edema to us. In cases of suspected obstruction and hydronephrosis, antegrade procedures are more suitable, especially when temporary urinary diversion is also needed. In cases of ureteral compression by pararenal fluid collections, puncture and temporary percutaneous drainage usually solve the problem. Leaks at the site of the ureteroneocystostomy are successfully treated by endourologic procedures, whereas surgical intervention is indicated in cases of ureteral necrosis; however, primary differentiation between leakage and ureteral necrosis is not possible. A success rate of 60% in cases of leakage justifies a primary endourologic approach. Five patients (24%) required subsequent surgery, but temporary urinary diversion prior to the operation was nonetheless helpful. Sixteen patients (76%) were cured by endourologic procedures alone. Only one procedure-related complication (4.7%) was observed. Invasive percutaneous and endoscopie uroradiologic techniques for the diagnosis and treatment of urologie complica¬ tions in the aftermath of renal transplantation may be considered safe.

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“…N. Oosterhof after kidney transplantation is open operative reconstruction. The specific treatment of choice is pyeloureterostomy, which consists of an anastomosis between the pelvis of the transplanted kidney and the native ureter [4, 181. Since the development of percu taneous techniques, transluminal dilation of ureteral strictures has become an accepted mode of treatment for obviating a potentially complicated operation [8,9,15,161. Patients with short strictures of the ureter are known to be the best candidates for endoscopic dilation [2], but experience with this technique in transplanted kidneys is rather limited [7-9, 13, 15, 161.…”

mentioning

confidence: 99%

Antegrade percutaneous dilation of ureteral strictures after kidney transplantation

Oosterhof

¹

,

Hoitsma

²

,

Debruyne

³

1989

View full text Add to dashboard Cite

Ureteral obstruction after renal transplantation is due mostly to retroperitoneal fibrosis in the area of surgical dissection, and pyeloureterostomy is the treatment of choice for such an obstruction. For confined strictures, especially at the site of the ureteroneocystostomy, endoscopic dilation may be a good alternative. Antegrade percutaneous dilation was used to treat six patients with ureteral stricture after kidney transplantation. Four patients had stricture at the ureterovesical junction, one a confined midureteral stricture, and one a secondary stricture at the site of pyeloureterostomy. Percutaneous antegrade dilation of the stricture to 14 Fr with semirigid fascial dilators and external ureteral stenting with a 12-Fr silicon splint for 6 weeks was successful in the four patients with ureterovesical junction obstruction, but not in the two other patients. Results were judged on the basis of serum creatinine concentration, renal ultrasonography, and intravenous urography (IVU). The follow-up period was 12-20 months (mean 15 months). None of the six patients died and perioperative morbidity was minimal.

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Balloon Dilation for Ureteral Strictures in Graft Kidneys

Cited by 23 publications

References 0 publications

Antegrade percutaneous dilation of ureteral strictures after kidney transplantation

Antegrade percutaneous dilation of ureteral strictures after kidney transplantation

Interventional Endourologic Procedures after Renal Transplantation

Antegrade percutaneous dilation of ureteral strictures after kidney transplantation

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