title: [Fistulas and ureteral strictures after kidney transplantation. Diagnosis and treatment].
abstract: We report our experience of 4 urine fistulas and 4 ureteral strictures after renal transplantation. Percutaneous nephrostomy was performed on all patients. The diagnosis was established by antegrade pyelography. Nephrectomy was performed on 2 patients because of failure of drainage and formation of an infected urine collection due to an extended ureteral necrosis. Abstention was elected in one case as renal function did not improve due to associated chronic rejection. In 5 cases, renal function quickly improved with drainage: 2 were operated on immediately, and one after failure of endo-urological treatment of a urine fistula. Antegrade dilatation has been used successfully in one stenosis. In the last case, a double pigtail stent allowed a urine fistula to close. Percutaneous nephrostomy seems to be best method of drainage when ureteral obstruction or fistula is suspected in renal transplant patients, and permits diagnosis by antegrade pyelography. Percutaneous management may be a satisfactory way of treatment for limited stenosis or fistulas.
authors.affiliation: Service d'Urologie, Hôpital Charles-Nicolle, Tunisie.
authors.forename: S
authors.initials: S
authors.lastname: Ben Fadhel
authors.forename: M
authors.initials: M
authors.lastname: el Ouakdi
authors.forename: T
authors.initials: T
authors.lastname: Ben Abdallah
authors.forename: K
authors.initials: K
authors.lastname: Hamza
authors.forename: M
authors.initials: M
authors.lastname: Ayed
authors.forename: R
authors.initials: R
authors.lastname: Hamza
authors.forename: S
authors.initials: S
authors.lastname: Zmerli
mesh_terms: D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D009403:Nephrostomy, Percutaneous; D011182:Postoperative Care; D011183:Postoperative Complications; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D014548:Urinary Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D014567:Urography
vernacular_title: Fistules et sténoses urétérales après transplantation rénale. Diagnostic et traitement.