Successful Salvage of Kidney Allografts Threatened by Ureteral Stricture Using Pyelovesical Bypass

Azhar, Raed A.; Hassanain, Mazen; Aljiffry, Murad; Aldousari, Saad; Cabrera, Tatiana; Andonian, Sero; Metrakos, Peter; Anidjar, Maurice; Paraskevas, Steven

doi:10.1111/j.1600-6143.2010.03137.x

Cited by 27 publications

(20 citation statements)

References 14 publications

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“…In 2010, Azhar et al reported using the Detour EAS as a salvage treatment in eight transplant patients with ureteric stenosis (17). Four patients had failed surgical intervention and in the remaining surgical intervention was not attempted due to high stricture location and/or high-risk surgery.…”

Section: Discussionmentioning

confidence: 99%

Extra-Anatomic Stent (EAS) as a Salvage Procedure for Transplant Ureteric Stricture

Tahir

Hakeem

White

et al. 2014

American Journal of Transplantation

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Ureteric stricture is the most common urological complication following renal transplantation. Management often involves endo-urological interventions and open surgery. The definitive treatment is surgical reconstruction to restore continuity. Where this is not possible or contra-indicated and a stent cannot be placed in the ureter, an extra-anatomic stent (EAS) could be used to bypass a complete ureteric obstruction. Using an existing nephrostomy tract, a percutaneous stent is placed in the kidney and is tunneled under the skin into the bladder establishing extraanatomical urinary drainage. We report the use of a novel EAS system in a patient with transplant ureteric stricture when antegrade stent placement or surgical reconstruction was not possible.

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Section: Discussionmentioning

confidence: 99%

Extra-Anatomic Stent (EAS) as a Salvage Procedure for Transplant Ureteric Stricture

Tahir

Hakeem

White

et al. 2014

American Journal of Transplantation

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“…The first bilateral use in individuals with retroperitoneal fibrosis was reported in 2013 [3] . Several smaller case series showed good long-term results up to 15 years [6][7][8] . Common problems were positive urine cultures, mostly with Candida species.…”

Section: Discussionmentioning

confidence: 99%

“…Their compositional analyses revealed infect stones. It has been argued that clinically relevant stone formation might be unlikely because of the large lumen of the SPBG tube (17 CH) [6] . Even taking the history of previous uric acid stone formation into consideration, we did not expect complete obstruction of the SPBG in the presented patient.…”

Section: Discussionmentioning

confidence: 99%

Complete Occlusion of a Subcutaneous Pyelovesical Bypass Graft (Detour® System) Caused by Uric Acid Stone Formation

Wilhelm

Schultze-Seemann²,

Miernik³

2014

Urol Int

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Subcutaneous pyelovesical bypass graft (SPBG) is a urinary diversion treatment option for ureteral obstruction. Initially its use was limited to palliative care patients. However, the indication profile has been extended to selected patients with benign conditions causing ureteral obstruction and hydronephrosis. Occlusion of SPBGs is rarely reported and mostly related to infections. We describe the clinical case of a patient with SPBG after iatrogenic ureteral stricture who was not suitable for other reconstructive treatment forms due to distinct retroperitoneal scarring after multiple previous surgeries. Several months after the SPBG insertion, the patient developed complete occlusion of the system with uric acid stone material. Sufficient endoscopic intervention was not feasible. After forced chemolitholysis, the stone mass could be completely dissolved. Since then the patient has remained symptom-free.

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“…Ureteral obstruction and ureteral leakage are the most common urinary complication after renal transplantation (Azhar, Hassanain et al 2010). The incidence related in literature varies from 3 to 8% (Fontana, Bertocchi et al;Smith, Windsperger et al;Kaskarelis, Koukoulaki et al 2008).…”

Section: Ureteral Obstructionmentioning

confidence: 99%

Surgical Complications of Renal Transplantation

Cassini¹,

Andrade²,

Tucci³

2011

Understanding the Complexities of Kidney Transplantation

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Successful Salvage of Kidney Allografts Threatened by Ureteral Stricture Using Pyelovesical Bypass

Cited by 27 publications

References 14 publications

Extra-Anatomic Stent (EAS) as a Salvage Procedure for Transplant Ureteric Stricture

Extra-Anatomic Stent (EAS) as a Salvage Procedure for Transplant Ureteric Stricture

Complete Occlusion of a Subcutaneous Pyelovesical Bypass Graft (Detour® System) Caused by Uric Acid Stone Formation

Surgical Complications of Renal Transplantation

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