BACKGROUND AND PURPOSE: 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. PATIENTS AND 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. CONCLUSION: 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.
BACKGROUND AND PURPOSE: 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. PATIENTS AND 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. CONCLUSION: 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: Andrzej Jerzy Wrona; Jarosław Zgajewski; Norbert Kopeć; Dominik Chodor; Paweł Kopcza; Stefan Klekot Journal: Cent European J Urol Date: 2017-10-17