Native ureteropyelostomy in the treatment of obstructive uropathy in adult renal transplant. Experience and technical alternatives

E. Trilla, D. Lorente, C. Salvador, J. Planas, J. Placer, A. Celma, C. Cantarell, F. Moreso, D. Seron, J. Morote

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

© 2013 AEU. Published by Elsevier Espaa, S.L.U. All rights reserved. Objective: To analyze and evaluate our experience in surgical treatment with the open approach of the complex ureteral stenosis after adult kidney transplantation in a tertiary level hospital in the last seven years. We have reviewed the different surgical options used.Patients and methods: A total of 589 consecutive adult renal transplants were performed fromJanuary 2005 to December 2012. Of these, 1.1% showed some degree of symptomatic obstructiveuropathy which after initial urinary diversion required open surgical approach using the ipsila-teral or contralateral native urinary tract. Characteristics of the patient, clinical examinationsperformed and surgical technique performed as well as their results are presented.Results: During the period under review, in 5 men and 2 women who had ureteral stenoses afterrenal transplant, 7 reparative surgeries were performed by open ureteropyelostomy, using ipsi-lateral native ureter in 6 cases and contralateral ureter in the remaining case. In one case,uretero-calicial anastomosis was performed due to severe pyelic shrinkage. There were no sig-nificant complications. Native kidney nephrectomy was not required for further complications.All the patients operated on had optimum plasma creatinine levels with resolution of previousdilatation.Conclusions: The initial percutaneous nephrostomy followed by open surgical repair usingnative ureter represents a definitive, valid and optimal alternative in terms of safety andpreservation of renal function.
Original languageEnglish
Pages (from-to)552-556
JournalActas Urologicas Espanolas
Volume38
Issue number8
DOIs
Publication statusPublished - 1 Jan 2014

Keywords

  • Obstructive uropathy
  • Renal
  • transplantation
  • Ureteropyelostomy

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