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Artificial ureters in renal transplantation
Sero Andonian1, Kevin C Zorn, Steven Paraskevas
1Division of Urology, Department of Surgery, Royal Victoria Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
Urology
|November 16, 2005
Summary
This study explores artificial ureters for treating ureteral strictures in kidney transplant patients when other methods fail. Early results show stable renal function without obstruction, suggesting a potential new treatment option.
Area of Science:
- Urology
- Transplant Surgery
- Biomaterials Science
Background:
- Ureteral strictures are a complication following renal transplantation, often managed with balloon dilation and stents.
- When endourologic treatments fail, surgical options like ureteroneocystostomy or pyeloureteral anastomosis are considered but have variable success rates.
Observation:
- This study reports the first two North American cases using silicone-polyester artificial ureters (pyelovesical bypass graft) for post-transplant ureteral strictures.
- These cases involved patients who had previously failed both endourologic and open surgical management.
Findings:
- Following implantation of the artificial ureter, both patients demonstrated stable renal function.
- No evidence of urinary obstruction was observed in either patient at 12 and 15 months post-procedure.
Implications:
- Silicone-polyester artificial ureters represent a potential alternative for complex ureteral strictures after renal transplantation.
- Long-term monitoring is crucial to assess the durability and potential complications, such as late encrustation and obstruction.