The kidney bridge procedure for bilateral ureteral loss.
Bilateral ureteral loss is an uncommon occurrence that challenges the usual reconstructive approaches. We developed a novel procedure, using autotransplantation of one kidney to bridge the ureteral deficit of the contralateral kidney. A 61-year-old woman developed long bilateral mid and distal ureteral strictures from idiopathic retroperitoneal fibrosis. The left kidney was autotransplanted to the right iliac fossa and the right ureter was anastomosed to the autotransplanted kidney's pelvis, followed by ureteroneocystostomy, all over a stent. This provided an intestine-free, physiologically normal system for draining both kidneys into the bladder. She had a stable creatinine of 1.7 mg/dL at 18 months postoperatively.
Hefty
Thomas R
TR
Section of Urology and Renal Transplantation, Virginia Mason Medical Center, Seattle, Washington 98111, USA. urotrh@vmmc.org
Corman
John M
JM
Sarram
Ali M
AM
D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D008875:Middle Aged; D014517:Ureteral Obstruction / Q000209:etiology / Q000601:surgery*