An unusual cause of recurrent bacteriuria in a kidney transplant recipient

A 17-year old Saudi male presented to the transplant clinic of the King Fahad National Guard Hospital, Riyadh two weeks after undergoing a living unrelated kidney transplant in India. Graft function was normal and routine urine culture grew Pseudomonas aeruginosa for which he was treated; a follow-up urine culture was negative. Five months later, routine urine culture again documented the presence of Pseudomonas while the patient continued to be asymptomatic with normal graft function. Abdominal ultrasound showed shrunken native kidneys and a normal graft. A slightly echogenic mass was detected in the bladder. Cystocopy showed a retained non-absorbable suture at the area of the uretero-vesical anastomosis. Cystoscopic removal of the suture was carried out following which urine cultures have remained persistently negative.