Percutaneous management of transplant ureteral fistulas: patient selection and long-term results.
Of 24 renal allograft recipients with urinary extravasation 14 (58%) with ureteral fistulas were selected for percutaneous management in an attempt to obviate secondary operative intervention. The initial procedure in all cases was placement of a percutaneous nephrostomy tube with subsequent internal or internal/external stenting. With a mean followup of 47 months, the percutaneous management proved definitive in 5 patients (36%) and palliative in 1 (7%). The other 8 patients (57%) subsequently required open operative intervention. With this study, we conclude that percutaneous techniques can provide long-term definitive management for at least some transplant ureteral fistulas. However, even in a highly selected group of patients success rates will be limited.
Department of Urology, Cleveland Clinic Foundation, Ohio 44195.
S C
SC
Campbell
S B
SB
Streem
M
M
Zelch
E
E
Hodge
A C
AC
Novick
D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D009403:Nephrostomy, Percutaneous; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014515:Ureteral Diseases / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D014548:Urinary Fistula / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*