title: Obstructive uropathy in the transplanted kidney: definitive management with percutaneous nephrostomy and prolonged ureteral stenting.
abstract: OBJECTIVE
  Renal transplantation is an effective treatment for end-stage renal disease. Ureteral stenosis is the most frequent urologic complication. We report our experience with percutaneous nephrostomy and antegrade ureteral stenting, which may offer a primary and definitive alternative to open surgery.
  
  
  METHODS
  Fifteen patients with renal allograft obstructive uropathy were managed with percutaneous nephrostomy and prolonged ureteral stenting.
  
  
  RESULTS
  Percutaneous nephrostomies were successfully performed in all 15 kidneys: In 13 patients, antegrade ureteral stenting was attempted, this being successful in 11 (85%). After prolonged ureteral stenting (mean duration 15 months), the stent was removed in eight patients, and six of them (75%) did not have recurrences. During follow-up, urea, creatinine, sodium, and potassium determinations and ultrasound scans were performed, and success was confirmed by the decline of creatinine and reduction in hydronephrosis. No major complication was observed.
  
  
  CONCLUSIONS
  Percutaneous nephrostomy and ureteral stenting is a safe and effective treatment for renal allograft obstructive uropathy. Prolonged ureteral stenting may offer a definitive treatment with low morbidity.
authors.affiliation: Department of Radiology, Laiko Hospital, Athens, Greece.
authors.forename: P
authors.initials: P
authors.lastname: Pappas
authors.forename: A
authors.initials: A
authors.lastname: Giannopoulos
authors.forename: K G
authors.initials: KG
authors.lastname: Stravodimos
authors.forename: G
authors.initials: G
authors.lastname: Zavos
authors.forename: T
authors.initials: T
authors.lastname: Alexopoulos
authors.forename: J
authors.initials: J
authors.lastname: Boletis
authors.forename: G
authors.initials: G
authors.lastname: Tzortzis
authors.forename: A
authors.initials: A
authors.lastname: Kostakis
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation; D009403:Nephrostomy, Percutaneous; D011183:Postoperative Complications / Q000628:therapy*; D015607:Stents; D014184:Transplantation, Homologous; D014517:Ureteral Obstruction / Q000209:etiology / Q000473:pathology / Q000628:therapy*