Ureteroscopic management of urological complications after renal transplantation

被引:35
|
作者
Basiri, A
Nikoobakht, MR
Simforoosh, N
Moghaddam, SMMH
机构
[1] Shahid Beheshti Univ Med Sci, Shaheed Labbafi Nejad Hosp, Dept Urol, Urol Nephrol Res Ctr, Tehran, Iran
[2] Shahid Beheshti Univ Med Sci, Shaheed Labbafi Nejad Hosp, Dept Trop Med & Infect Dis, Urol Nephrol Res Ctr, Tehran, Iran
来源
关键词
renal transplantation; ureteroscopy; urological complications;
D O I
10.1080/00365590510007838
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objective. To determine the feasibility, safety and efficacy of diagnostic and therapeutic ureteroscopy in renal allograft ureters. Material and methods. We reviewed 1560 consecutive renal allografts performed between June 1989 and February 2002. A total of 28 patients ( 1.8%) had indications for an endoscopic procedure on the allograft ureter, as follows: obstructive ureteral calculi with a history of failed extracorporeal shock-wave lithotripsy, n = 6; suspected ureteral stricture, n = 3; upwardly migrated ureteral stents, n = 9; and ureteral stricture at the ureteroneocystostomy site, n = 10. Ureters were anastomosed to the bladder using the Leadbetter - Politano and Lich - Gregoire methods in six and 22 cases, respectively. Ureteroscopies were performed with a semi-rigid 9.8 F Wolf ureteroscope. Results. Identification of the ureteral orifice and insertion of a guide-wire into it was successful in 19 cases (68%). If we exclude the 10 patients with ureteral stricture, ureteroscopy was successful in 13/18 cases (72%). Four ureteral calculi (67%) were removed with the ureteroscope. Seven out of nine migrated stents (78%) were retrieved. Four patients with ureteral stricture at the ureteroneocystostomy site (40%) underwent successful ureteral dilatation and double-J ureteral catheters were also inserted. Diagnostic ureteroscopy was successful in all cases. Two complications ( one urinary leakage and one symptomatic urinary tract infection) occurred and were managed conservatively. Conclusions. Ureteral endoscopy is a safe and effective method for the management of urological complications after renal transplantation. This procedure can be considered the first choice, in preference to percutaneous and antegrade modalities.
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页码:53 / 56
页数:4
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