title: Long-term outcome of subcutaneous pyelovesical bypass in extended ureteral stricture after renal transplantation.
abstract: OBJECTIVE
  Extended ureteral stricture is a rare complication of renal transplantation. Its management remains challenging. The aim of our study was to report our 15 years of experience with subcutaneous pyelovesical bypass graft (SPBG) in selected renal transplant patients who presented with extended ureteral stricture and who were not eligible for open ureteral reconstruction.
  
  
  METHODS
  Seven patients were operated on between 1992 and 2007-six men and one woman-with a mean age at surgery of 47 years (range 30-67 y).
  
  
  RESULTS
  We report no encrustation or dislodgment with a mean follow-up of 6 years (range 1-14 y). Postoperative mortality was null. During the follow-up, three patients died: Two from an extrarenal cause with a functional SPBG and a stable renal function; one from septic shock after fungic colonization of the prosthesis. Asymptomatic urinary tract infection developed in two other patients, with no renal function impairment.
  
  
  CONCLUSIONS
  Despite a 47% rate of infection (3/7), SPBG can be a safe and efficient alternative to open surgery to save many years of graft function in renal transplant patients who present with extended ureteral stricture.
authors.affiliation: Department of Urology, Saint Louis Hospital , Paris, France.
authors.forename: Cécile Olivia
authors.initials: CO
authors.lastname: Muller
authors.forename: Paul
authors.initials: P
authors.lastname: Meria
authors.forename: François
authors.initials: F
authors.lastname: Desgrandchamps
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D040521:Subcutaneous Tissue / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000209:etiology* / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*