María Fernanda Rosero Morillo*

Specialist in Urology, Central University of Ecuador, Quito-Ecuador

*Corresponding Author: María Fernanda Rosero Morillo, Specialist in Urology, Central University of Ecuador, Quito-Ecuador.

Received: March 7, 2022; Published: May 13, 2022

Abstract

Introduction: The incidence of urological complications in renal transplant patients has been reported from 2 to 3%. Currently, clinical and surgical management guidelines or treatment consensus have not been established for post-surgical complications in transplant patients, which is why describing ureteral reconstruction in a transplanted kidney due to stenosis in the upper third of the kidney serves to determine the best therapeutic surgical option with the flap to prevent loss of kidney function.

Clinical Case: A 51-year-old male patient, with a history of kidney transplantation 1 year ago, diagnosed with hydronephrosis due to stenosis of the transplanted ureter and urinary tract infections due to repeated nephrostomy and several failed endourological procedures.

Conclusions: Ureteral stenosis as a postoperative complication in kidney transplantation is one of the most important challenges for the reconstruction of the urinary tract, nephrostomy is the first line of treatment, however when traditional techniques fail, open ureteral anastomosis is a safe technique. and with good results in order to maintain the renal function of the transplanted kidney and offer the patient a better quality of life.

Keywords: Ureteral Stenosis; Ureteral Anastomosis; Transplanted Kidney

References

1. Streeter EH., et al. “The urological complications of renal transplantation: a series of 1535 patients”. BJU International 7 (2002): 627-634.
2. Stenberg A and Lackrana G. “A new bioimplant for the endoscopic treatment of vesicoureteral reflux: experimental and short-term clinical results”. Journal of Urology 2 (1995): 800-803.
3. Elder JS., et al. “Endoscopic therapy for vesicoureteral reflux: a meta-analysis. I. reflux resolution and urinary tract infection”. Journal of Urology 2 (2006): 716-722.
4. Yucel S., et al. “Endoscopic vesicoureteral reflux correction in transplanted kidneys: does injection technique matter?” Journal of Endourology10 (2010): 1661-1664.
5. Kumar S., et al. “Uretera obstruction following renal transplantation: causes, diagnosis and management”. The British Journal of Radiology1044 (2014): 20140169.
6. He Z., et al. “Endoscopic incision for obstruction of vesicoureteric anastomosis in transplanted kidneys”. BJU International 1 (2008): 102-106.
7. Gdor Y., et al. “Holmium: yttrium-aluminum-garnet laser endoureterotomy for the treatment of transplant kidney ureteral strictures”. Transplantation9 (2008): 1318-1321.
8. Rivera-Astorga H., et al. “Experience in the treatment of ureterovesical junction stenosis in kidney transplant patients”. Revista Mexicana de Urología 4 (2018): 290-297.
9. Juaneda B., et al. “Endourological management is better in early-onset ureteral stenosis in kidney transplantation”. Transplantation Proceedings 5 (2005): 569-578.
10. Ariza-Heredia EJ., et al. “Urinary tract infections in kidney transplant recipients: role of gender, urologic abnormalities, and antimicrobial prophylaxis”. Annals of Transplantation 18 (2013): 195-204.
11. Ariza-Heredia EJ., et al. “Impact of urinary tract infection on allograft function after kidney transplantation”. Clinical Transplantation 06 (2014): 683-690.
12. Giessing M. “Transplant ureter stricture following renal transplantation: surgical options”. Transplantation Proceedings 1 (2011): 383-386.
13. Hau HM., et al. “Management of urologic complications in renal transplantation: a single-center experience”. Transplantation Proceedings 05 (2014): 1332-1339.
14. Stoffel J., et al. “Mp85-19 Treatment of Transplant Ureter Strictures with Ureteral Dilation and Ureteroneocystostomy: Outcomes From a 14 Year Experience”. Journal of Urology 04 (2015): e1074.
15. Duty BD and Barry JM. “Diagnosis and management of ureteral complications following renal transplantation”. Asian Journal Urology04 (2015): 202-207.
16. A Breda., et al. “Renal Transplanation”. European Urology Association (2019).
17. Osband AJ., et al. “Time of extraction of kidneys from deceased donors and impact on the results”. American Journal of Transplantation 16 (2016): 700.
18. Loffroy R., et al. “Management of postbiopsy renal allograft arteriovenous fistulae with selective arterial embolization: immediate and long-term results”. Clinical Radiology (2008): 657.
19. Patel P., et al. “Prophylactic ureteral stents in kidney transplant recipients: a multicentre randomised controlled trial of early versus late extraction”. American Journal of Transplantation 17 (2017): 2129.
20. Slagt IK., et al. “A randomised controlled trial comparing intravesical ureteroneocystostomy with extravesical ureteroneocystostomy in living-donor kidney transplant recipients”. Kidney International 85 (2014): 471.
21. Thiel GT., et al. “Investigation of kidney donation as a risk factor for hypertension and microalbuminuria: findings from the Swiss prospective follow-up of living kidney donors”. BMJ Open 6 (2016): 22.
22. Ibrahim HN., et al. “Long-term consequences of kidney donation”. The New England Journal of Medicine 360 (2009): 459.
23. Kehinde EO., et al. “Complications associated with the use of non-absorbable sutures for ureteroneocystostomy in kidney transplant operations”. Transplantation Proceedings 32 (2000): 1917.
24. Tavakoli A., et al. “Impact of stents on urological complications and healthcare expenditure in kidney transplant recipients: results of a prospective, randomized clinical trial”. Journal of Urology 177 (2007): 2260.
25. Kortram K., et al. “Perioperative events and complications in nephrectomy of minimally invasive living donors: a systematic review and meta-analysis”. Transplant (2016).
26. Chu KH., et al. “Long-term results from living kidney donors: a unique 29-year center experience”. Nephrology (Carlton) 17 (2012): 85.
27. Suttle T., et al. “Comparison of urological complications between ureteroneocystostomy and ureteroureterostomy in renal transplantation: a meta-analysis”. Experimental and Clinical Transplantation 14 (2016): 276.
28. Redfield RR., et al. “Predictors and outcomes of late graft function after living-donor kidney transplantation”. Transplant International 29 (2016): 81.
29. Aubert O., et al. “Long term outcomes of transplantation using kidneys from expanded criteria donors: prospective, population-based cohort study”. BMJ 351 (2015): h3557.
30. Irish WD., et al. “A risk prediction model for delayed graft function in the current era of deceased donor kidney transplantation”. American Journal of Transplantation 10 (2010): 2279.

Citation

Citation: Maria Fernanda Rosero Morillo. “Ureteral Anastomosis of Ureter Transplanted to Native Ureter by Ureteral Stenosis in the Upper Third as a Complication After Renal Transplantation: Clinical Case". Acta Scientific Clinical Case Reports 3.6 (2022): 26-30.

Copyright

Copyright: © 2022 María Fernanda Rosero Morillo. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.