Ureteroscopic evaluation in renal transplant recipients. Academic Article uri icon

Overview

abstract

  • Percutaneous access and antegrade intervention have been the gold standard for the management of renal and ureteral complications in the renal transplant patient. We reviewed 540 consecutive renal allografts performed between July 1991 and September 1996 to determine the feasibility and morbidity of diagnostic and therapeutic ureteroscopy in renal allograft ureters. Of these, 14 patients (2.5%) had indications for endoscopic intervention of the allograft ureter. Four patients had obstructive ureteral calculi, three had migrated double-pigtail stents, three had persistent suspicious urinary cytology findings necessitating diagnostic ureteroscopy, three had persistent funguria, and one had multiple ureteral filling defects seen on retrograde ureteropyelography. Ureteropyeloscopy was successful in 93% of the patients. A diagnosis was made in all cases, including the one unsuccessful ureteroscopy, as this patient had allograft ureteral necrosis preventing passage of the endoscope into the renal pelvis. All of the migrated stents could be seen, and all but one was retrieved. Two of the patients with persistent funguria did have renal fungal balls, which were removed endoscopically, and the other case yielded a urothelial biopsy positive for fungus. All of the ureteral calculi were removed endoscopically. The only complication was ureteral perforation, which occurred in the patient with ureteral necrosis. Transplant ureteral endoscopy is a technically challenging intervention, but both diagnostic and therapeutic ureteroscopy can be performed with acceptable outcomes and minimal morbidity. One should consider ureteroscopy as an alternative to percutaneous and antegrade modalities, as these methods carry significant morbidity.

publication date

  • April 1, 1998

Research

keywords

  • Kidney Transplantation
  • Ureteroscopy

Identity

Scopus Document Identifier

  • 0031749410

Digital Object Identifier (DOI)

  • 10.1089/end.1998.12.135

PubMed ID

  • 9607439

Additional Document Info

volume

  • 12

issue

  • 2