Successful long-term outcome using existing native cutaneous ureterostomy for renal transplant drainage

We report our long-term experience with a preexisting native cutaneous ureterostomy via an ipsilateral transplant ureteral native ureterostomy for transplant drainage without native nephrectomy.

Between 1993 and 1998, 5 patients without a usable bladder had undergone previously urinary diversion via cutaneous ureterostomy. All patients had a well functioning cutaneous ureterostomy for a mean plus or minus standard deviation of 18+/-12 years before renal transplantation. No patient had a history of stomal stenosis, recent urinary tract infection or pyelonephritis.

All 5 patients continued to have a functioning renal transplant at last mean followup of 36+/-6.6 months. Complications included stomal retraction due to postoperative weight gain requiring revision in 2 cases and ureteroureteral anastomotic stenosis treated with endopyelotomy in 1. Mean serum creatinine at last followup was 1.5+/-0.6 mg./dl.

Of the complications that we present only 1 may be attributed to the singularity of our procedure. Our experience suggests that a preexisting native cutaneous ureterostomy may serve as a receptacle for transplant ureteral drainage in select patients with excellent long-term function.