Antegrade endopyelotomy for treatment of ureteropelvic junction obstruction in transplanted kidneys.
OBJECTIVE
Little is known about the incidence and treatment of ureteropelvic junction (UPJ) obstruction of renal grafts. We report on three cases treated by endopyelotomy.


METHODS
Graft function declined in three patients 98, 135, and 144 days after kidney transplantation. Acute rejection was excluded by renal biopsy. Ultrasonography revealed a dilated collecting system, and a percutaneous nephrostomy tube was placed. An antegrade nephrostogram showed UPJ obstruction. Percutaneous antegrade endopyelotomy was performed with the cold-knife technique, and the area was stented for 6 weeks using a 14F/8.2F Smith endopyelotomy stent.


RESULTS
No intraoperative or postoperative complications occurred. The endopyelotomies were successful, and the creatinine clearances returned to normal.


CONCLUSIONS
Antegrade endopyelotomy in patients with UPJ obstruction of a renal graft is feasible and effective. Normal kidney function was restored after correction of the obstruction.
Schumacher
Martin
M
Department of Urology, University of Bern, Bern, Switzerland. Martin.Schumacher@insel.ch
Studer
U E
UE
Danuser
H
H
D004724:Endoscopy; D006801:Humans; D007682:Kidney Pelvis; D016030:Kidney Transplantation; D009403:Nephrostomy, Percutaneous; D011183:Postoperative Complications / Q000601:surgery; D015607:Stents; D014463:Ultrasonography; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*