title: Classification of ureteral stenosis and associated strategy for treatment after kidney transplant.
abstract: OBJECTIVE
  Ureteral stenosis is a common complication after a kidney transplant. Treatment for ureteral stenosis ranges from interventional procedures to open surgery. The aim of this study is to present classification for ureteral stenosis and recommend the targeted strategy for effective treatment.
  
  
  METHODS
  Twelve cases of ureteral stenosis were diagnosed among 193 kidney transplants, of which 91 were from a live donor and 102 from a deceased donor. The mean age was 46.22 ± 13.23 years. The diagnosis of ureteral stenosis includes serum creatinine elevation, hydronephrosis, and presence of stricture on a pyelogram. The criterion for classification is based on the severity of stricture.
  
  
  RESULTS
  One of ureteral stenoses was classified as grade 1, six were grade 2, and five were grade 3. Of 12 cases, 10 were live-donor kidney transplant, 4 had lymphocele, and 2 had a hematoma after transplant. The corresponding strategy for each grade of ureteral stenosis is as follows: grade 1, ureteral stent reinsertion; grade 2, cutting balloon dilatation or endoscopic incision of stenosis; grade 3, open surgery urinary tract reconstruction. All cases were successfully treated using these strategies.
  
  
  CONCLUSIONS
  This classification of ureteral stenosis provides guidance for effective management and avoids unnecessary procedures. In this series, ureteral stenosis was significantly associated with a live donor and surgical complications.
authors: WA Liver and Kidney Transplant Service, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia. bulang.he@health.wa.gov.au
authors: Bulang
authors: B
authors: He
authors: Alexandra
authors: A
authors: Bremner
authors: Ying
authors: Y
authors: Han
mesh_terms: D000328:Adult; D002102:Cadaver; D003404:Creatinine / Q000097:blood; D004106:Dilatation / Q000295:instrumentation; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000145:classification / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D019520:Living Donors; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D012720:Severity of Illness Index; D015607:Stents; D014515:Ureteral Diseases / Q000145:classification* / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*
chemical_list: D003404:Creatinine