Transurethral incision of ureteroneocystostomy strictures in kidney transplant recipients.
OBJECTIVE
To report the treatment of patients who presented with vesico-ureteric stricture after kidney transplantation, using a minimally invasive endourological approach.


METHODS
Patients (10 men and four women, mean age 34 years, range 22-55) were assessed at presentation by serum creatinine level, ultrasonography and intravenous pyelography when the serum creatinine level was < 200 micromol/L. When there was hydronephrosis of the allograft a percutaneous antegrade pyelogram was taken, followed by inserting a nephrostomy. After decompression a stent nephrostomy was passed into the bladder and the strictures at the vesico-ureteric junction incised along the stent during cystoscopy.


RESULTS
All 14 patients were treated endourologically by an endoscopic incision through the bladder; 13 fared well and one died from sepsis and transplantation problems. The mean follow-up was 8 months.


CONCLUSIONS
Simple incision of the stricture via cystoscopy was safe and effective, and succeeded in most patients. The endourological management of ureteric lesions is feasible and is currently our first-line management of ureteric complications after kidney transplantation.
Katz
R
R
Department of Urology, Hadassah and Hebrew University Hospital, Jerusalem, Israel. rank@cc.huji.ac.il
Pode
D
D
Gofrit
O N
ON
Shenfeld
O Z
OZ
Landau
E H
EH
Golijanin
D
D
Shapiro
A
A
D000328:Adult; D003558:Cystoscopy / Q000379:methods*; D003559:Cystostomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D024162:Second-Look Surgery; D015607:Stents; D014517:Ureteral Obstruction / Q000209:etiology / Q000601:surgery*; D014519:Ureterostomy / Q000379:methods*; D001745:Urinary Bladder Diseases / Q000601:surgery*