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Transurethral incision of ureteroneocystostomy strictures in kidney transplant recipients
Author(s) -
Katz R.,
Pode D.,
Gofrit O.N.,
Shenfeld O.Z.,
Landau E.H.,
Golijanin D.,
Shapiro A.
Publication year - 2003
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1046/j.1464-410x.2003.04455.x
Subject(s) - medicine , cystoscopy , surgery , percutaneous nephrostomy , hydronephrosis , kidney transplantation , ureteric stent , stent , transplantation , nephrostomy , pyelogram , urology , urinary fistula , urinary system , percutaneous , fistula
OBJECTIVES To report the treatment of patients who presented with vesico‐ureteric stricture after kidney transplantation, using a minimally invasive endourological approach. PATIENTS AND METHODS Patients (10 men and four women, mean age 34 years, range 22–55) were assessed at presentation by serum creatinine level, ultrasonography and intravenous pyelography when the serum creatinine level was < 200 µmol/L. When there was hydronephrosis of the allograft a percutaneous antegrade pyelogram was taken, followed by inserting a nephrostomy. After decompression a stent nephrostomy was passed into the bladder and the strictures at the vesico‐ureteric junction incised along the stent during cystoscopy. RESULTS All 14 patients were treated endourologically by an endoscopic incision through the bladder; 13 fared well and one died from sepsis and transplantation problems. The mean follow‐up was 8 months. CONCLUSIONS Simple incision of the stricture via cystoscopy was safe and effective, and succeeded in most patients. The endourological management of ureteric lesions is feasible and is currently our first‐line management of ureteric complications after kidney transplantation.