Abstract:

BACKGROUND: Ureteric obstruction is the most common complication after renal transplantation. Traditionally, this complication has been managed with open surgery. Currently, minimally invasive endourological techniques may offer an appropriate alternative to open surgery with the development of endourological techniques and the accumulation of experience.
OBJECTIVE: To sum up the clinical effect of endourological techniques on ureteric obstrucion in transplanted kidneys.
METHODS: Between February 2001 and October 2010, 23 cases of uretertic obstruction in transplanted kidneys were treated by endoscopical technique. After the obstruction was dilated with balloon or completely cut, two double-J stents were placed in the ureter for 4-6 weeks. During follow-up, renal function tests, B ultrasound examination and wash-out renal scintigraphy were performed.
RESULTS AND CONCLUSION: Balloon dilation was performed in four patients and endoscopic incision was performed in 19 patients. All procedures resulted in successful incision of the obstruction. No complication was recorded during or after the procedure. At the mean follow-up of 6-108 months, 14 patients have ureteral patency and stable renal function, nine patients presented with recurred obstructive uropathy. Among them, two patients required permanent change of ureteral cathers, one patient required permanent nephrostomy, six patients required open surgical correction (four cases successful and two cases failed). Endourological technique for the ureteric obstruction in transplanted kidney is safe and effective. However, if the first endourological procedure fails, the recurrence rate of repeated endoscopic insicion is high.