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Endoscopic retrograde stenting for allograft hydronephrosis.
D B Sigman1, J J Del Pizzo, G N Sklar
1Department of Surgery, University of Maryland School of Medicine, Baltimore, USA.
Journal of Endourology
|April 2, 1999
Summary
Retrograde stenting is a safe and effective treatment for renal allograft obstruction, often performed without general anesthesia. This minimally invasive approach offers a high success rate for transplant recipients experiencing ureteral issues.
Area of Science:
- Nephrology
- Urology
- Transplant Surgery
Background:
- Ureteral obstruction affects 2-10% of renal transplant recipients.
- Traditional antegrade endourologic intervention carries significant morbidity.
- Investigating less invasive alternatives is crucial for patient outcomes.
Purpose of the Study:
- To assess the feasibility of retrograde stenting for renal allograft ureteral obstruction.
- To determine if retrograde stenting can be performed with minimal morbidity.
- To evaluate the necessity of general or regional anesthesia for this procedure.
Main Methods:
- Ninety-seven patients with renal allograft hydronephrosis were identified.
- Retrograde stenting was attempted under local anesthesia, with sedation if needed.
- Procedures were repeated under general/regional anesthesia if initial attempts failed.
Main Results:
- Retrograde stenting successfully managed 88% of patients.
- Most procedures (95%) used local anesthesia and/or sedation, avoiding general anesthesia.
- No morbidity was directly associated with retrograde stenting; failures indicated serious complications.
Conclusions:
- Retrograde stenting is a highly successful and low-morbidity option for hydronephrotic renal allografts.
- The procedure can often be performed without general or regional anesthesia.
- Failure to achieve retrograde stenting warrants suspicion of severe allograft complications.