Transplant ureter stricture: Acucise endoureterotomy and balloon dilation are effective.
METHODS
Eight patients with ureteral stricture after renal transplantation underwent minimally invasive treatment with Acucise incision or balloon dilation. Acucise endoureterotomy was used to treat four patients with strictures at the ureterovesical anastomosis, and balloon dilation was used to treat four patients with a ureteroureterostomy stricture. Success was defined as an acceptable serum creatinine concentration in the absence of hydronephrosis with at least 1 year of follow-up.


RESULTS
Acucise endoureterotomy for ureterovesical anastomosis stricture was successful in two of three patients (67%) with a mean follow-up of 20 months. One patient had an indeterminate outcome. Balloon dilation of strictured ureteroureterostomy was successful in three of four patients (75%) with a mean follow-up of 23.7 months. Three of the four patients with previously failed open revision were treated successfully with endourologic techniques. The two patients in whom treatment failed had strictures >/=1.5 cm and manifested comorbidities including diabetes mellitus.


CONCLUSIONS
As our results are comparable to those of other published series, endourologic management of transplant ureteral stenosis is a reasonable strategy.
Bhayani
Sam B
SB
Division of Urology (Surgery), Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Landman
Jaime
J
Slotoroff
Craig
C
Figenshau
R Sherburne
RS
D000328:Adult; D002404:Catheterization; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D014517:Ureteral Obstruction / Q000628:therapy*