Retrograde stenting for obstruction of the renal transplant ureter.
OBJECTIVE
To present our experience with retrograde stent placement and stent exchange for transplant ureteral obstruction.


METHODS
A review of our renal transplant database was performed to identify all renal transplant patients who underwent attempted retrograde ureteral stenting for allograft ureteral obstruction or attempted allograft ureteral stent exchange between May 1992 and April 2004. A retrospective review was performed.


RESULTS
Forty patients underwent 52 attempted retrograde ureteral stent placements, and 11 patients underwent a total of 27 attempted stent exchanges. In patients with ureteral obstruction, the most common clinical signs and symptoms were nausea, vomiting, diarrhea, abdominal pain, fever, decreased urine output, edema, and an elevated serum creatinine. Of the 52 cases of allograft ureteral obstruction and attempted retrograde ureteral stent placement, 28 (53.8%) were managed successfully with retrograde ureteral stenting. Of the 27 attempted stent exchange procedures, a successful exchange was accomplished in 23 cases (85.2%).


CONCLUSIONS
Cystoscopy with retrograde allograft stent placement is a reasonable first approach to the management of transplant ureteral obstruction and is successful in more than one half of cases.
Gerrard
Edward R
ER
Division of Urology, University of Alabama, Birmingham, Alabama 35294-3411, USA.
Burns
John R
JR
Young
Carlton J
CJ
Urban
Donald A
DA
Hammontree
Lee N
LN
El-Galley
Rizk
R
Kolettis
Peter N
PN
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000379:methods*; D012189:Retrospective Studies; D015607:Stents; D014517:Ureteral Obstruction / Q000209:etiology* / Q000601:surgery*