title: Primary percutaneous treatment of transplant ureteral strictures using tandem stents.
abstract: OBJECTIVE
  To evaluate outcomes of primary (first-occurrence) treatment of renal transplant ureteral strictures using tandem parallel internal double-pigtail stents.
  
  
  METHODS
  A retrospective electronic chart review, including demographics, medical history, stricture intervention, and outcomes, was performed of patients with renal transplants with first-occurrence ureteral obstructions or leaks reported in a transplant nephrology database over a 4-year period, with a focus on patients treated primarily with tandem stents.
  
  
  RESULTS
  Of 27 patients with first-occurrence ureteral obstruction or ureteral leak, 18 (67%) were treated primarily using tandem internal stents, with 15 (83%) of 18 stent-free for a minimum 90 days of follow-up. There was no significant difference between outcomes for male versus female patients (P>.99) or early versus late strictures (P = .53). Urinary tract infections (UTIs) occurred in 14 (78%) of 18 patients with tandem stents in place. Four patients were hospitalized<48 hours with UTI and sepsis; there were no other major complications.
  
  
  CONCLUSIONS
  Patients with renal transplants can be successfully managed nonsurgically using tandem ureteral stents for the primary treatment of first-occurrence ureteral stricture. These patients may require more intensive monitoring for UTIs.
authors.affiliation: Division of Vascular and Interventional Radiology, Mayo Clinic Hospital, Phoenix, AZ 85054, USA. skriegshauser@mayo.edu
authors.forename: J Scott
authors.initials: JS
authors.lastname: Kriegshauser
authors.forename: Sailen G
authors.initials: SG
authors.lastname: Naidu
authors.forename: Raymond L
authors.initials: RL
authors.lastname: Heilman
authors.forename: Eric A
authors.initials: EA
authors.lastname: Huettl
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: Ferlic
authors.forename: Erik P
authors.initials: EP
authors.lastname: Castle
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Hentz
mesh_terms: D000328:Adult; D000368:Aged; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000379:methods; D011859:Radiography; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*