Renal autotransplantation: A final option to preserve the kidney after an iatrogenic ureteral injury

Abstract

Background: Ureteral injuries are not very common and can occur after many surgical procedures. Kidney salvage is desirable. Renal autotransplantation is a final option for some cases. In this case, we report an autotransplantation of the kidney after an iatrogenic injury of the ureter with totally extraperitoneal approach.Case report: A 41 years old female underwent left endoscopic ureterolithotomy with holmium laser for ureteral calculi. An iatrogenic ureteral injury, probably ureteral avulsion, occurred. After multiple interventions, she referred to us with a nephrostomy tube. Imaging was performed and left renal autotransplantation was chosen as surgical management. The approach was totally extraperitoneal. No alteration of renal function or of urine outflow was observed during the follow up.Conclusions: The report supports the safety and efficacy of renal autotransplantation.

Case report series: management of complete ureteral avulsion with review of the relevant literature

“…In the literature, 55% [17] of 31 cases had avulsion of the right ureter and 45% [14] had it in left ureter. [3][4][5][6][7][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Two of our cases had right ureter avulsion, and one patient had left ureter avulsion which was in line with the literature.…”

“…Repair of long-term defect of the ureter, especially of the proximal ureter, is a particularly difficult surgical challenge. No strict recommendations are available about the treatment of long ureteral lesions [24]. Early intervention was preferred in our cases.…”

Sonographic Assessment of Renal Transplant Anastomotic Pseudoaneurysm: A Case Study

“…3 Renal autotransplantation is a method of treating proximal ureteral injury, renal artery aneurysms, chronic kidney pain, and some complex cases of renal tumors. [4][5][6] It is a favorable alternative to conventional nephrectomy and prevents a patient from experiencing loss of renal function. 4 However, since autotransplantation is a challenging surgery and a patient's recovery can be slow, the multi-disciplinary team must have excluded all other treatments of the underlying pathology.…”