title: Subcutaneous nephrovesical bypass in kidney transplanted patients.
abstract: BACKGROUND
  Renal transplant ureteral stricture or obstruction is a rare but devastating complication after renal transplantation.
  
  
  OBJECTIVE
  To determine the efficacy and complications of subcutaneous prosthetic ureters as a salvage procedure in transplanted kidneys with recurrent ureteral obstruction.
  
  
  METHODS
  5 subcutaneous prosthetic ureters were inserted in 5 kidney recipients who had recurrent ureteral stenosis and failed endoscopic and open reconstructive surgeries. The prosthetic ureter consisted of an internal silicone tube covered by a coiled PTFE tube. The proximal end of the tube was introduced in the transplanted kidney percutaneously, the tube was passed through a subcutaneous tunnel, and the distal end was inserted in the bladder through a small suprapubic incision.
  
  
  RESULTS
  The mean follow-up of patients was 11.3 months. One of the patients re-operated two days after the procedure because of urinary leakage from the distal end of the prosthetic ureter. No infection or tube encrustation was encountered.
  
  
  CONCLUSIONS
  Subcutaneous prosthetic ureter is a safe alternative for permanent percutaneous nephrostomy in transplanted kidneys with obstructed ureter and failed endoscopic and open procedures.
authors.affiliation: Department of Urology and Renal Transplantation, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Yazdani
authors.affiliation: Isfahan Kidney Disease Research Center, Department of Urology and Renal Transplantation, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: M R
authors.initials: MR
authors.lastname: Gharaati
authors.affiliation: Department of Urology and Renal Transplantation, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Zargham
keywords: Kidney transplantation; Nephrovesical bypass; Ureteral obstruction